Avoiding the most common Medicare trap

Supplement Plans vs Advantage Plans

Medicare presents two primary pathways: Original Medicare (Parts A and B) paired with a Medicare Supplement Plan (Medigap), or Medicare Advantage Plans (Part C). Traditional Medicare covers 80% of costs, and Supplement Plans  bridge the “gap” for the remaining 20%. 

Medicare Advantage Plans, on the other hand, are structured care programs that often provide additional benefits such as dental or vision coverage with the limitation of a more restricted network of healthcare providers available to you.

The Medicare Trap

A common misconception among seniors is that they can easily switch from an Advantage Plan to a Supplement Plan. Rather, if you initially choose a Medicare Advantage Plan when you turn 65, switching to Traditional Medicare with a Supplement Plan can challenging. After the initial 6-month window post-enrollment, medical underwriting (answering detailed health questions) is required to get on a Supplement Plan and you may be denied based on your health. 

This means if you've started with an Advantage Plan and later wish to adopt a supplement, you might face difficulties, potentially making it impossible to qualify for a Medicare Supplement Plan.

The Silver Lining: "Trial RIghts"

Medicare offers a safeguard known as "trial rights." If you initially choose an Advantage Plan upon starting Medicare, you can test it for up to 12 months. If unsatisfied, you can switch to a Medicare Supplement Plan without medical underwriting, as if you had selected it from the outset. In California is also the protection afforded by the “Birthday Rule”.

Making an Informed Decision

The options you face upon enrolling in Medicare emphasize the need for informed decisions. The initial choice between Original Medicare + Supplement Plan or an Advantage Plan is pivotal and can impact future healthcare coverage options. Contact us today to speak with an expert Medicare agent and make the right choice for you.