What to Look for in Medicare Supplement and Medicare Advantage Plans

Ask the Experts by Dan H. Tripp CLU

Q: I'll be turning 65 in a few months. I keep hearing about Medicare Supplement plans and Medicare Advantage plans. What should I look for?

A: The first thing you need to know is if you are within 3 months of turning 65 or turned 65 less than 3 months ago, you are in the "open enrollment" period, meaning you are guaranteed coverage regardless of your health. You have a 7-month window to get Medicare without having to answer any health questions. Don't wait; if you are 90 days past your 65th birthday, you may be ineligible, based on your health.

The major difference between Medicare Supplement (Medigap) plans and the Advantage plans is who administers them. Advantage plans - Medicare Part C - replace parts A & B, except for hospice care, which remains in Part A. Many include prescription drug coverage, and offer dental and vision benefits. These plans are administered by private insurance companies, not Medicare. Premiums are individually set, and can be as low as $0.00, but typically have very high deductibles and copays. Keep in mind that premiums can be raised and/or benefits changed or dropped.

Medigap plans are standardized by Medicare, and offer several options, depending on what you'd like covered. There is a core plan A, and several more plans, with 11 different plans available in Michigan. The major difference is that Advantage plans require a network of doctors or providers, and are often limited to where you reside. Medigap plans are accepted by any doctor or provider that accepts Medicare payments, meaning that you can take your plan with you if you relocate. Also, each plan's benefits are the same, regardless of what company you choose to underwrite you.

This can be a very confusing decision; sit down with a qualified agent who can help walk you through the process and answer your questions. Look beyond the premiums and make sure you get the best value for your dollar. Check into the history of any company you're thinking about using, review their rate history and how often they change their drug coverage. But don't wait too long. Use the time you have to make the best decision for YOU!

Dan H. Tripp is an independent agent with over 27 years' experience helping individuals, families and small business navigate the complexities of life, disability and long-term care insurance. He holds a CLU designation from The American College, and is a member in good standing with NAIFA and the Society of Financial Service Professionals. He can be reached at 313-478-4337 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Tripp is a member of The Family Center's Association of Professionals.

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