Page 115 - South Mississippi Living - November, 2021

“We Put the CARE in Medicare!”
50 Years of Local Service
With the Medicare Annual Enrollment Period upon us, I always get questions with regards to the difference between the two plans.
The easiest way to explain the difference is to give you a quick history lesson. Back in the 90’s, the only option available for retirees was the Red, White and Blue Medicare Card and a Supplement with NO Drug coverage. Yes, you read that correctly, NO DRUG COVERAGE.
When the government started listening, besides wanting drug coverage, they found out that many seniors wanted
a work style health plan as a Medicare option.
In 2005, Seniors finally had the option to buy prescription drug coverage with their Medicare coverage. They were also offered an Employer/Work Style Health plan option which is called “Medicare Advantage”.
A Medicare Advantage Plan is basically Group Health Insurance for Seniors. It covers doctor, hospital, and drugs just like your current or past employer-based health plan. It has a network of doctors and hospitals, it has copays, it has annual deductibles and annual max out of pockets. Which means the most it will cost you in a given year.
The network is the key difference. All employer-based health plans use a Network of Doctors and Hospitals
in order to control cost. The network means: if you go see Doctor “AB” and he or she sends you to Doctor “CD” in
Mobile or New Orleans, what is the first thing you must do before you make
an appointment? You must make sure Doctor “CD” takes your insurance. Meaning you must make sure he or she is in your Health plans Network.
The Medicare Supplement works totally different. Everyone takes Medicare for the most part, so you do not have the network issues. Your Red, White and Blue Medicare Card is primary, and
your supplement is secondary. Meaning you show your Medicare card and your supplement card. Medicare only covers doctor and hospital, so you will need to purchase a separate drug plan.
So what plan is best for you??
First: you DO NOT lose your Medicare if you enroll in a Medicare Advantage Plan. This is a complete misunderstanding and it drives me crazy when I hear someone make that statement. In fact, you must have Medicare in order to enroll in a Medicare Advantage plan.
Just remember, the Advantage plan was designed to mimic the work health coverage you had for the last 20-30 years. If you liked your work style health coverage, you would like the advantage plan. If you did not like your work coverage, then you probably will not like the Advantage plan.
The question remains, what plan is best for you? To answer this, you need to ask yourself a few questions.
Do you plan to travel? If so, where? Again, the Advantage plan is a network-
based plan and it may not be an option if you are traveling all over the country. If you are back and forth to Orange Beach or Destin, the network might work.
Do you mind the networks and copays? If you do not like or want copays and network issues, then don’t buy a Medicare Advantage plan.
Are you sick or healthy? If you are fighting Cancer, you need to look at
the copay cost versus just buying a supplement that does not have copays. Look at the total annual cost for each plan.
Are you looking for hassle free or do you mind a little hassle, if it can save you money? The advantage plans are cheaper, but you will have the hassle of the network and copays. The Supplement is hassle free, but it cost more. The bottom line, buy a plan that puts your mind at ease. Insurance is about having that peace of mind, so you don’t worry and give yourself Shingles. Because they HURT!!
Now you are armed with some knowledge that will help you make the correct decision. Call my office for a free side by side comparison. And remember, That’s why We Put the CARE in Medicare.
Gary Smith, Owner & Agent 1831 Dr. Reuben P. Morris Dr, Pascagoula, MS 39567
228.762.3334
SOUTH MISSISSIPPI Living | www.smliving.net
November 2021 | 115
www.garysmithagency.net