Medicare Options to Consider

Navigating through the maze of Medicare can be frustrating and a cumbersome experience. There are really 2 main options people have that are eligible for Medicare. The agents at Affordable Health and Medicare Insurance will help you determine which option is best for your situation. The 2 basic options for Medicare supplemental coverage are traditional Medicare supplement plans “Medigap” policies or Medicare Advantage plans.You can add coverage to Original Medicare or choose a Medicare Advantage plan instead.



Original Medicare
(Part A + B)

You may add a standalone Part D plan, a
Medicare supplement plan or both to Original
Medicare (Parts A & B).

Parts A + B

Parts A + B plus Part D prescription coverage

Parts A + B plus a Medicare supplement plan

Parts A + B plus both Part D prescription
coverage and a Medicare supplement plan

Medicare Advantage (Part A + Part B + Part C + Part D)

You may choose to get your benefits through a Medicare Advantage plan (Part C). Many plans come with built-in prescription drug coverage.

Part C with no drug coverage

Part C with built-in Part D prescription coverage

Part C plus a standalone Part D prescription coverage plan in limited circumstances

What Plan is the right one?

This is where most people have a hard time figuring out what to do. Some make the mistake and ask a friend or get on the same plan as a spouse without taking the following into consideration:

What are my healthcare needs?

What prescriptions am I taking?

Do I expect to travel?

Do I want to keep my doctors?

What is my overall health?

It is very important that you consider the answer to these questions with a licensed health insurance agent/Medicare specialist. The agents at AffordableHealth and Medicare Insurance are well versed in the details of the different options that are available to you. We must stay current with our licensing and carrier training every year, so that we can best help you decide what option is best for you and your situation. Please call us or schedule an online appointment so that we can sit down with you and review the options.

Let’s dive into detail about the differences between the Medicare Supplement and Medicare Advantage Plan.

Medicare Supplements

Medicare supplements are health insurance policies sold by private insurers that work in conjunction with and help cover the GAPS in Original Medicare. They are also sometimes called “Medigap Plans” or “secondary plans”. You must be entitled to Part A and enrolled in Part B.

NOTE: Medicare supplements do not cover prescription drugs so, unless you have creditable coverage through the VA (or similar) or as part of a retirement package, you will need to add a Part D Prescription drug plan.

Why Do People Choose
Medicare Supplements?

You get to choose your doctors and hospitals. There are no networks.

Referrals are not necessary. Want to see a specialist? Call and make an appointment!

Your policy is guaranteed renewable. You cannot be dropped because you are sick.

ou can predict your costs. Once you pay the premium, it is easy to determine your liability.

What do Medicare supplements NOT cover?

Long Term Care


Routine hearing

Routine vision

Prescription drugs (You must add a Part D plan for this!) vision

Medicare Advantage (Part C)

Medicare Advantage is a type of health policy approved by Medicare that is administered by private companies. Medicare Advantage plans combine Medicare Parts A, B, and D into one plan and usually use a network of providers and hospitals. These plans are most offered as HMOs and PPOs. Though they are provided by private insurers, Medicare Advantage plans are tightly regulated and funded by CMS. The private insurers are accepting all the risk for your care. You must continue paying your Part B premium.

Many describe Medicare Advantage plans as feeling a bit like Group insurance you may have had while working. If you choose an HMO, you usually must choose a primary care physician (PCP) who manages your care and provides referrals to specialists. For those who want a bit more flexibility in choosing doctors or the ability to go out-of-network, a PPO structure might fit the bill. When accessing care, there may be deductibles and co-insurance up to a maximum out-of-pocket amount. Once this maximum is reached, the private insurer is responsible for all hospital and medical costs for the remainder of the year.

In addition, Medicare Advantage often offers benefits above and beyond Original Medicare such as dental, routine vision, and routine hearing (among others).Medicare Advantage is very popular with consumers and enrollment is growing rapidly.

These are often the plans seen on television and radio commercials offering premium “as low as $0”. The key to customer satisfaction is talking with your agent at Affordable Health and Medicare Insurance to make sure that your needs are understood and that your doctors, hospitals, and pharmacies are part of the plan’s network

Which is best…Medicare supplements or Medicare Advantage?

The answer to this varies from person to person. Satisfaction depends largelyon a customer’s expectations, budget, and style of care they prefer. We find that people who don’t mind paying a premium and who want maximum doctor choice are often good fits for supplements. Also, people who travel frequently or who want to minimize co-pays and co-insurance often prefer this type of coverage as well. For Medicare Advantage plans, the lower premium options are a very popular feature.

For those willing to utilize doctor networks, get referrals, and pay co-pays and co-insurance when they access care, Advantage plans are a nice option. The extra benefits (such as routine dental, vision, and hearing) not covered by Medicare are also very enticing and popular. The agents at Affordable Health and Medicare are well versed and highly proficient in presenting the Medicare options to you in a way that will make sense and be easy to understand. Our goal is to first understand your situation and present plans that will best fit your needs. Please call us: 936-372-5498 or schedule an appointment online.