Original Medicare
Parts A and B leave many gaps in coverage. Part A is hospital insurance, and
Part B is medical insurance. A Medicare Supplemental Insurance policy works
with Original Medicare so that you do not have to pay deductibles or co–pays,
for instance. It also covers services that Original Medicare does not, like
healthcare needs while traveling. If you have a Medigap policy, you cannot
enroll in Medicare Advantage (Medicare Part C).
Medicare Advantage
Plans are administered by private insurance companies and cover the same
services as Original Medicare. They may provide more coverage, too, and there
are annual out-of-pocket spending limits. Most of them come with
self-administered Prescription Drug coverage. Usually, there are restrictions
on where you get your health care services, and you have to be referred to see
a specialist.
Medigap
Plans allow you to choose your provider, and you don’t need pre-authorization
for treatment or a referral to see a specialist. You need a separate Medicare
Prescription Plan. You can choose a Medicare Advantage Plan instead of Original Medicare. While a
Medicare Advantage Plan may provide more coverage than a Medigap Plan, there
may be restrictions on whom you can see or where you can go for your services.
If you have a Medicare Advantage Plan, you cannot get a Prescription Drug (Part
D) plan. For a breakdown of the differences, see http://www.medicarerights.org/fliers/Medicare-Advantage/Differences-Between-OM-and-MA.pdf?nrd=1.
Premium customer/patient service