Medicare Supplement vs Advantage in Frederick, MD
Tradeoffs, not winners
Neither type of plan is better for everyone. Here is how they differ on the things Frederick residents ask us about most.
Side by side
At a glance
| Question | Medicare Supplement | Medicare Advantage |
|---|---|---|
| Doctors and hospitals | Any provider in the country that accepts Medicare | Plan network, with different rules for out of network care |
| Monthly plan premium | Paid on top of your Part B premium; varies by plan letter, carrier and how the carrier prices | Many plans have a low or $0 plan premium; you still pay your Part B premium |
| When you get care | Plan pays part or all of what Original Medicare leaves, depending on the plan letter | Copays or coinsurance set by the plan, up to a yearly maximum out of pocket |
| Prescription drugs | Not included; add a Part D plan | Often included in the plan |
| Extra benefits | Not part of the plan; dental, vision and hearing are bought separately | Often include dental, vision, hearing or fitness benefits, which vary by plan |
| Can it change each year? | Benefits of a plan letter are standardized; premiums can change | Benefits, costs and networks can all change each January |
Results vary by person. Plan details and prices change, and rates can change without notice.
Walk through it
Five steps to a clear choice
Step 1: Start with what Original Medicare leaves open
Original Medicare, meaning Part A and Part B, covers a great deal, but it does not cover everything. You still pay deductibles and coinsurance, and there is no yearly limit on what you could pay for covered care. Both Supplement and Advantage plans exist to deal with that gap, in very different ways.
The bottom line: the question is not which is better, but which way of handling the gap suits how you live and get care.
Step 2: How a Medicare Supplement works
A Medicare Supplement, also called Medigap, sits on top of Original Medicare. Medicare pays its share first, then your Supplement pays some or all of the rest, depending on the plan letter you pick (Plan G and Plan N are two you will hear about often). Because you stay in Original Medicare, you can use any doctor or hospital that accepts Medicare.
A Supplement does not include prescription drugs, so most people add a separate Part D plan. Rates can change without notice, and how a carrier sets its prices over time matters as much as the first-year number.
The bottom line: broad provider choice and steady costs at the point of care, in exchange for a premium and a separate drug plan.
Step 3: How a Medicare Advantage plan works
A Medicare Advantage plan replaces Original Medicare with a plan from a private insurer that Medicare approves. It covers everything Parts A and B cover, usually adds drug coverage, and often adds dental, vision or hearing benefits. You use the plan’s network, and you share the cost of services through copays or coinsurance, with a yearly cap on what you pay for covered care.
Benefits, costs and networks can all change each January, so a plan that fits this year should be checked again each fall.
The bottom line: lower premiums and extras in exchange for working within a network.
Step 4: Questions that are specific to Frederick
Frederick Health Hospital is the main hospital in town, and many residents are happy to stay close to home. Others travel to Baltimore, about 46 miles east, or to the Washington area for a specialist. Ask yourself which group you are in, because it decides how much a network matters to you.
If you or your spouse worked at Fort Detrick, Hood College, Frederick Community College or for the federal government, ask whether you have retiree coverage that interacts with Medicare. We are not affiliated with any of these, but we help people sort out how their coverage fits together. When you wonder if a particular Frederick doctor or hospital works with a plan you like, remember that network participation varies by plan. Call us to check whether a facility is in yours.
The bottom line: list your doctors and hospital first. Plans come second.
Step 5: Timing and switching
Your first chance to pick comes around your 65th birthday. After that, switching between the two types is limited to certain windows, and moving to a Supplement later can involve health questions. Please talk with us before you cancel any coverage so you never end up with a gap.
The bottom line: the first choice is the easiest one to make, so it is worth making with care. Our turning 65 page shows the months.
Your next step
Compare plans with a local specialist
We can price out both types with your doctors and prescriptions in mind and explain what we find. There is no cost to you.