Medicare vs. Medicare Supplemental vs. Original Medicare

IF YOU’RE 65 OR OLDER, YOU’RE ELIGIBLE FOR MEDICARE.

If you’re younger than 65 but have certain disabilities or end-stage renal disease, you might also be eligible. There are several Medicare options to choose from, and which one you select will depend on your particular situation.

Here are five key questions for you to think about as you consider what plan is right for you:

• How much health care will I use each year?
• How much can I afford to pay in monthly premiums?
• How much can I afford to pay in out-of-pocket costs?
• Do I need access to a national network of doctors and hospitals?
• Do I want extras like dental, vision and gym memberships with my plan?

If you choose Medicare or Medicare Advantage, you’ll still need to pay your Medicare Part B premium. Here are some features of Medicare plans:

Original Medicare

• Includes Part A (hospital care) and Part B (doctors, medical procedures and equipment).
• Does not include coverage for prescription drugs (Part D).
• Does not cover dental, vision or hearing services.
• Allows you to see any health care provider that takes Medicare.
• Offers no maximum for out-of-pocket expenses.

Medicare Supplemental Plans (also called Medigap)

• Provide benefits by a private health insurance company.
• Include all the benefits of Original Medicare (Parts A + B), plus extra coverage for “gaps” like copays, coinsurance, and deductibles.
• Provide no coverage for Part D prescription drugs,
• Offer dental and vision add-on options in some plans for an additional premium.
• Have yearly out-of-pocket limits.

Medicare Advantage (MA) Plans (also called Part C)

• Include coverage for health care services not covered by Medicare, such as dental, vision and hearing.
• Allow most plans to cover prescription drug costs.
• Might have extra benefits, such as health and wellness programs.
• Often provide emergency or urgent care when traveling abroad.

When deciding between Medicare, Medicare Supplemental and Medicare Advantage plans, you need to consider cost, coverage levels and doctor networks.

Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts.  HAP Medicare Complete Duals (HMO D-SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.

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