Here we are in the 2027 annual enrollment period (AEP). I would like to address two topics:
- The general difference between a Medicare supplement (medigap) plan and Medicare
advantage plans (MA or MAPD). - In network vs out-of-network services.
First, Medicare supplement vs Medicare Advantage. There are many, many documents out there that may better explain these differences. The way I look at it is pretty easy, pay me now or pay me later. In the most general terms, a Medicare supplement plan often carries a higher monthly premium, but when you use it, the costs could be next to nothing.
Conversely, with a Medicare advantage, with or without a prescription drug plan, you pay next to nothing (in many instances) monthly, but when it is used you pay copays, copays, and more copays.
A Medicare supplement plan does not include a prescription drug plan, also any medical facility that accepts Medicare accepts your supplement plan.
Second, the other big difference is network availability. If you have a Medicare Advantage plan the medical facility may or may not accept your insurance.
Network most often pertains to Medicare advantage plans. Generally, there are two types of plans, a preferred provider organization (PPO) or the health maintenance organization (HMO). The HMO deals with a stricter network, usually there are no out-of-network benefits, with some exceptions. The majority of plans available in Montrose, right now, are PPO and they carry in and out-of-network benefits. You will receive the greatest benefit by staying in network. There are out of network benefits, but you will pay more.
This is an extremely abbreviated conversation on these subjects. In our area it is important to review your annual notice of change (ANOC) and consult with your agent yearly. This enrollment period ends December 7. You can search plans by zip code on my website at www.wmforest.com.
I am a licensed agent in this area and have many carrier options. Medicare consultations and conversations are free. We are here to answer questions and assist with enrollment during this busy time, and any time of year.
Any content, resident submissions, guest columns, advertisements, and advertorials are not necessarily endorsed by or represent the views of Best Version Media LLC (BVM) or any municipality, homeowners associations, businesses, or organizations that this publication serves. BVM is not responsible for the reliability, suitability, or timeliness of any content submitted, inclusive of materials generated or composed through artificial intelligence (AI). All content submitted is done so at the sole discretion of the submitting party.
