The Difference Between Medicare Advantage Plans and Medicare Supplement Plans

Medicare Advantage plans and Medicare Supplement plans are both types of health insurance plans that patients are eligible to enroll in once they reach Medicare age. However, there are some key differences between how these plans are billed.

Medicare Advantage OR Replacement plans are offered by private insurance companies that have contracted with Medicare. These plans replace Medicare and are the primary insurance.

These plans typically offer a wider range of coverage than original Medicare, and may cover services not typically covered by Medicare such as exams and therapies.

Medicare Supplement plans are also offered by private insurance companies, but they don't replace original Medicare. Instead, they supplement original Medicare by covering some of the costs that original Medicare doesn't cover, such as copays, deductibles, and coinsurance.

Secondary plans not affiliated with Medicare are typically plans offered by the patient's retirement program. These are secondary to Medicare, and also may cover services not typically covered by Medicare such as exams and therapies. Common examples of this include federal employee programs such as BCBS FEP or Aetna Mail Handlers Benefit Plan (MHBP).

Here are some helpful tips to determine if a plan is a Medicare Advantage Plan or a Medicare Supplement Plan.

Medicare Advantage or Replacement Plans are PRIMARY and you will never bill to Medicare.

Tips to help determine if an insurance is a Medicare Advantage or Replacement plan:

The Insurance card will say "Advantage" , "Advantra" , "Medicare Solutions"
There is a Copay listed on the insurance card

Medicare supplement plans are SECONDARY to Medicare - Medicare will be billed first, and Medicare will automatically forward the claim to the Medicare Supplement plan.

Tips to help determine if an insurance is a Medicare Supplement plan:

It may say "Plan G" , "Plan F", or "Supplement Plan"
On the back of the card, it will typically say not to send claims to the payer, and to submit them directly to Medicare. Some patients may have a commercial insurance as their secondary if insurance from their spouse's employer, or the employer they retired from, if health benefits were included in their retirement package.

READY FOR A BETTER BILLING SOLUTION? WE GOT YOU!

The Difference Between Medicare Advantage Plans and Medicare Supplement Plans

Here are some helpful tips to determine if a plan is a Medicare Advantage Plan or a Medicare Supplement Plan.

Medicare supplement plans are SECONDARY to Medicare - Medicare will be billed first, and Medicare will automatically forward the claim to the Medicare Supplement plan.

READY FOR A BETTER BILLING SOLUTION? WE GOT YOU!

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