Advantage Primetime
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Medicare Advantage (HMO) vs Medicare Supplemental Insurance
At Capital Health Plan, Medicare members are offered Medicare Advantage (HMO) plans. Medicare Advantage plans are different than Medigap (Medicare Supplemental Insurance) plans. This is because we are a Health Maintenance Organization and not a supplement to Original Medicare. Capital Health Plan Medicare Advantage plans actually become your Medicare and provide all of your Medicare coverage. Medicare members wondering if the Medicare Advantage plan is the right choice for them should know the difference between a Medicare Advantage and a Medigap plan.
The Medigap plan is a supplement to Original Medicare. It can help pay some of the costs that Original Medicare does not cover, like copayments, coinsurance, and deductibles. Original Medicare generally pays 80% of the cost of services after meeting deductibles (when they apply). The patient is responsible for the deductible and 20% of the cost. Costs vary by policy and by company. Some prevention services may not be covered. Medigap plans purchased after 2006 do not include prescription drug coverage, so individuals need an additional prescription drug plan or Medicare Part D plan. The Medigap premiums, deductibles, copayments, coinsurance and the extra cost of a prescription drug plan can add up.
Capital Health Plan’s Medicare Advantage plans are an excellent value. There are no deductibles – just copayments or coinsurance to pay. Some services have a $0 copayment. The CHP plans are comprehensive and offer all the benefits of Original Medicare plus MORE. They include prescription drug coverage (Medicare Part D) and wellness benefits not generally covered by supplemental plans. There is no need to worry about primary and secondary payers, no need to file claims or seek reimbursement like there could be with a Medigap plan.
If you have additional questions about the different Medicare plans please call our Member Services department.
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