Medicare Supplement vs Medicare Advantage plans in Tampa Florida
Which should you choose?

If you live in the Tampa Florida region and you have your original Medicare coverage secured, you will have a choice of options for improving your coverage.  You may combine your Original Medicare plan with a Medicare Supplement plan, or you can sign up for a Medicare Advantage plan. Two out of three people in Tampa, choose the Medicare Supplement option, one third choose the Medicare Advantage option.  The Medicare Advantage option is growing in popularity.  So, which option is right for you? A brief explanation of the workings of both options may help.

Good to know:  Before purchasing a health plan, ask questions.  Call the member services department of the health plan you're considering and ask: Which doctors, hospitals, clinics or pharmacies participate in the plan?  How much does it cost to go out of network?  Am I covered during a travel emergency?  What is the premium and out-of-pocket costs?  What is the most I'll have to pay out of my own pocket to cover expenses?  Exactly what benefits are covered by the plan and what isn't covered?  How are disputes about a bill or service handled?  Then verify the information you were given by comparing it to the plan's benefit details.

How A Medicare Supplement Plan Works
A Medicare Supplement plan is designed to fill in the "gaps" in your Original Medicare coverage. Medicare supplement plans don't work like most health insurance plans.  They don't actually cover any health benefits.  Instead, if you incur a medical bill, these plans cover the portion of the bill that Medicare does not cover.  These costs can include:

• Your Medicare deductibles.
• Your coinsurance.
• Hospital costs if your stay runs beyond the Medicare covered hospital days limitations.
• Skilled nursing facility costs if your stay runs beyond the Medicare covered skilled nursing facility limitations.

Here's how Medicare supplement plans in Tampa, FL work: You pay a monthly premium for your Medicare supplement plan.  In return, the plan pays most of your out-of-pocket expenses.  How much the plan pays, depends upon the plan type you select.  For example, if you go to see a physician, Medicare will only pay 80% of the bill.  You are responsible for paying the remaining 20%.  However, you are covered by a Medicare supplement plan, the supplement plan would pay the 20%.  You would owe nothing.

There are 10 standardized plans available – labeled A, B, C, D, F, G, K, L, M and N – that cover anywhere from four to nine of these benefits:


• Medicare Part A coinsurance for hospital costs (up to an additional 365 days after Medicare benefits are used).
• Medicare Part B coinsurance, copayment.
• First three pints of blood for a medical procedure.
• Part A hospice care coinsurance or copayment.
• Skilled nursing facility care coinsurance.
• Part A deductible.
• Part B deductible.
• Part B excess charges.
• Foreign travel emergencies.


Keep in mind, all 10 Medicare supplement plans cover the coinsurance and 100 percent of hospital costs for Medicare Part A, but after that, plans differ in what they cover. With Original Medicare, you are free to see any doctor who accepts Medicare patients, with no referrals required.




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How Medicare Advantage plans work in Florida

Medicare Advantage plans (also known as Medicare Part C) combine doctor, hospital and often drug coverage into one plan.  Some may cover routine dental, vision and hearing needs, and may offer other services. Most Advantage plans offer prescription drug coverage.

Medicare Advantage plans are offered by private health insurance companies.  These insurance companies provide consumers with Advantage plan coverage. In turn, rather than Medicare paying a physician or hospital for services provided, Medicare pays an ongoing, predetermined amount to the insurance company for providing the Advantage plan coverage.

Medicare Advantage plans usually have copays and deductibles, but many limit the total amount you will have to pay for medical expenses out of pocket each year. Medicare Advantage plans work like the managed care plans you may have had during your working years.  You will have to receive your care from doctors, hospitals, and other providers within the plan's network. Plans can be health maintenance organization (HMO), or preferred provider organization (PPO).  If you have an HMO, you can only visit doctors and hospitals in those networks.  PPO plans have out-of-network benefits as well.  Visits to a specialist often require referrals, and some types of care may require advance approval.  There are several distinct physician / hospital networks in the Tampa Florida region.  If you have a doctor or facility preference, be sure to confirm their participation in the plan's associated network - before you purchase the plan.

Whichever option you choose, it is an important choice.  Be sure to speak directly with a Medicare insurance professional before you make your decision.

Good to know:  Ask for a discount.  You can potentially reduce the cost of your medical bills by asking for a discount upfront.  It may seem unconventional, but many hospitals and practitioners offer certain discounts for which you may be eligible.  For example, some hospitals are part of networks that will reduce your medical bills by a certain percentage if you pay over the phone.  More often than not, these discounts are only available to consumers who ask for them.  Depending on your economic status or the price of your procedure, some medical facilities offer additional discounts that can be paired with your medical insurance to substantially reduce the cost of your procedure.  For example, it's not uncommon for hospitals to offer discounts of up to thirty percent for qualifying customers.

Even if you don't find a discount related to your particular situation, your doctor or hospital may provide you with valuable information about discounts you can use in the future.






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