When it comes to your health, compromise isn’t always the best choice.
For seniors living along the beautiful Southwest Michigan lakefront, choosing Medicare coverage can feel overwhelming or even frustrating. There are low-premium Medicare Advantage plans, Medicare Supplement plans, prescription drug coverage, and a long list of other considerations. The plan with the lowest monthly premium isn’t necessarily the plan that will give you the greatest freedom or the most predictable costs when you actually need medical care.
For some people in St. Joseph, Stevensville, Bridgman, and the surrounding Southwest Michigan communities, Original Medicare combined with a Medicare Supplement (Medigap) plan may be the better choice.
That doesn’t mean Medicare Advantage is a bad choice. It can be an excellent option for someone who wants to keep monthly premiums low and is comfortable with the plan’s network and cost-sharing structure.
The question is really this:
What matters most to you when it comes to your healthcare?
You Want the Freedom to Choose Your Own Doctors
Some people don’t want their Medicare insurer determining which doctors and specialists they can see among other things. They want the freedom to choose their healthcare providers based on experience, reputation, recommendations from their primary care physician, or simply who they trust.
Medicare Advantage plans use provider networks, and the rules for seeing providers outside those networks, as well as referral and authorization requirements, vary by plan.
With Original Medicare and a Medicare Supplement, the situation is fundamentally different.
As a general rule, Original Medicare with a Medicare Supplement gives you the freedom to see virtually any doctor or healthcare provider across the country who accepts Medicare, without worrying about Medicare Advantage network restrictions.
Your primary care physician and other healthcare providers you trust can help guide your care without your Medicare Advantage network determining which specialists you can use.
For someone who wants maximum control over their healthcare choices, that freedom can be worth paying more for.
You Travel or Spend Winters Outside Michigan
Portability can be particularly important for Southwest Michigan retirees.
Many people who live around St. Joseph, Stevensville, and Bridgman enjoy spending part of the winter somewhere warmer. Florida is a particularly popular destination for Michigan snowbirds, and many retirees also travel throughout the country during retirement.
If you spend several months outside Michigan, you may not want your healthcare coverage tied to a Medicare Advantage network.
With Original Medicare and a Medicare Supplement, your coverage travels with you. If you are traveling in Florida or another state and need medical care, you can generally use any doctor or hospital that accepts Medicare.
You don’t have to spend your winter wondering whether the doctor you need is part of your Michigan Medicare Advantage network.
For people who travel frequently, that nationwide portability can provide tremendous peace of mind.
You’re Willing to Pay More for Predictable Healthcare Costs
There is a trade-off with Medicare Supplement coverage.
It isn’t a $0-premium solution.
You will pay a monthly premium for your Medicare Supplement in addition to your Medicare Part B premium. That premium will very likely increase over time, and that higher monthly cost is something you need to be comfortable with.
But there is another side to the equation.
The trade-off is straightforward: pay more consistently for coverage that can provide much greater freedom and predictability when serious medical care is needed.
A Medicare Supplement such as Plan G pays the applicable remaining Medicare cost-sharing after the Part B deductible, making your medical expenses considerably more predictable than they might otherwise be.
We generally recommend looking at Medigap Plans F, G, and N, along with High-Deductible Plan G for people who prefer a lower premium in exchange for taking on a high deductible up front. You can see our recommended Medicare Supplement plans here.
Medicare Advantage takes a different approach. Some plans have a $0 monthly premium, which can be very attractive. But the monthly premium is only one part of the cost.
When you actually use healthcare, your plan may have copayments, coinsurance, deductibles, and other cost-sharing. Those expenses are subject to the plan’s annual maximum out-of-pocket limit.
If you remain healthy, your actual medical expenses may be relatively modest. But none of us knows what our healthcare needs will look like five, ten, or fifteen years from now. Unlike Medicare Advantage plans, Medicare Supplement policies require acceptable health to qualify outside your initial open enrollment period.
A $0 Premium Can Look Very Different When You Need Serious Medical Care
This is one of the most important things to understand when comparing Medicare Advantage with Original Medicare and a Medicare Supplement.
Most people don’t choose a Medicare plan expecting to develop cancer, need major surgery, or spend significant time in the hospital.
We’ve seen real people face these situations — people who were perfectly healthy when they enrolled in Medicare and never imagined they would suddenly need extensive medical treatment.
Most of us know someone who has gone through chemotherapy. Many of us know someone who has had to go through it more than once.
Then the conversation changes very quickly.
Your doctor tells you that you have cancer.
You need chemotherapy.
And suddenly, the cost-sharing structure of your Medicare plan becomes much more important than it seemed when you were simply comparing monthly premiums.
Under Original Medicare, chemotherapy received in a doctor’s office, freestanding clinic, or hospital outpatient setting generally involves 20% coinsurance after the Part B deductible. A Medicare Supplement can cover that cost-sharing according to the benefits of the particular Medigap plan.
Medicare Advantage works differently. There is no Medicare Supplement sitting behind an Advantage plan to pick up the member’s cost-sharing. The Medicare Advantage plan establishes its own copayments, coinsurance, deductibles, and other cost-sharing for covered services.
For many Medicare Advantage plans, chemotherapy can involve significant cost-sharing.
A treatment that costs thousands of dollars can therefore leave a patient responsible for a substantial amount until the plan’s annual maximum out-of-pocket limit is reached.
And serious treatment doesn’t always fit neatly into one calendar year.
Someone can undergo extensive treatment late in one year and continue treatment into the next year, when a new plan year and a new annual cost-sharing structure begin.
This is why you have to look beyond the monthly premium when evaluating Medicare Advantage.
Pay particular attention to the plan’s cost-sharing for expensive medical services, including cancer treatment, hospitalization, surgery, and other major medical care.
A plan that looks inexpensive when you’re healthy can have a very different financial impact when you actually need substantial medical treatment.
Medicare Advantage Can Still Be the Right Choice
It’s important to make this clear: we offer Medicare Advantage plans as well as Medicare Supplement plans.
We’re not suggesting that everyone should choose Medigap.
Medicare Advantage can be an excellent choice for someone who wants to keep their monthly Medicare expenses as low as possible, is comfortable with the plan’s provider network, and likes the additional benefits some Medicare Advantage plans provide.
Some people simply prefer paying little or nothing each month and accepting the plan’s cost-sharing when they use healthcare.
Others would rather pay a higher monthly premium because they place a higher value on provider freedom, nationwide portability, and predictable medical expenses.
Neither decision is automatically right or wrong.
The better choice depends on how you actually use healthcare and what you value most.
If you’d like to take a broader look at Medicare options available in Michigan, our guide to Medicare plans in Michigan explains the differences between Medicare Advantage and Medicare Supplement coverage, including provider networks, flexibility, costs, and how where you live can affect your choices.
You Can Add Other Coverage When You Need It
One consideration that is sometimes overlooked is dental, vision, and hearing coverage.
Original Medicare and Medicare Supplement plans generally do not provide routine dental, vision, and hearing coverage.
If those benefits are important to you and you don’t have other coverage available, you may want to consider a separate dental, vision, and hearing plan.
We’ve put together additional information about these types of plans for people who want to explore that option.
Learn more about Dental, Vision & Hearing Coverage
What About Medicare Advantage With Additional Supplemental Protection?
Some people choose Medicare Advantage and then add supplemental indemnity protection designed to help with certain out-of-pocket expenses.
That can be a reasonable strategy for someone who wants to keep the monthly cost of their primary Medicare coverage lower while adding another layer of financial protection.
But there is an important distinction to remember:
Additional supplemental protection doesn’t turn a Medicare Advantage plan into Original Medicare.
The Medicare Advantage plan’s provider network, referral requirements, authorization rules, and other plan provisions still apply.
That’s why the question isn’t simply, “Which plan costs less?”
The better question is:
Which type of coverage fits the way you want to receive healthcare?
Who Should Seriously Consider a Medicare Supplement?
A Medicare Supplement may deserve serious consideration if you:
- Want the freedom to choose virtually any doctor or healthcare provider who accepts Medicare.
- Don’t want your healthcare choices tied to a Medicare Advantage network.
- Travel frequently outside Michigan.
- Spend part of the winter in Florida or another state.
- Have doctors and specialists you want to keep using.
- Prefer predictable medical cost-sharing over the possibility of higher costs when you need extensive care.
- Can comfortably afford the monthly Medicare Supplement premium.
- Want to plan for potentially significant healthcare expenses later in life rather than focusing only on today’s premium.
If several of those points describe you, Original Medicare with a Medicare Supplement may be worth a serious look.
Is a Medicare Supplement Right for You?
There isn’t one Medicare plan that is right for everyone.
The right choice depends on your doctors, prescriptions, travel habits, budget, healthcare priorities, and how comfortable you are with the different cost structures.
If you live in St. Joseph, Stevensville, Bridgman, or the surrounding Southwest Michigan area, we can help you compare both approaches.
We offer Medicare Advantage and Medicare Supplement plans, so our goal isn’t to tell you what you should buy before understanding your situation.
Our goal is to help you understand the trade-offs and determine which type of Medicare coverage makes the most sense for you.
An Independent View of Your Medicare Options
One of the advantages of working with an independent Medicare agent is that you’re not limited to one insurance company’s products.
Maple Valley Insurance Group works with numerous insurance companies offering Medicare Advantage and Medicare Supplement plans. Some companies specialize primarily in Medicare Supplements, while others offer both Medicare Advantage and Medicare Supplement products. That gives us the ability to compare options across different carriers rather than simply comparing one company’s Medicare Advantage plan with that same company’s Medicare Supplement.
Our perspective comes from working with these products across numerous insurance companies and helping people evaluate how different plans fit their healthcare needs, doctors, travel habits, and budget.
We’re not starting with the assumption that one type of Medicare coverage — or one insurance company — is right for you. We’re starting with your needs and looking at the available options from there.
That can be especially valuable if you’re trying to decide whether to stay with your current coverage, switch Medicare Advantage plans, or consider moving to Original Medicare with a Medicare Supplement.
Ready to Talk Through Your Medicare Options?
At this point, you may have a pretty good idea of which direction makes more sense for you — or you may still have questions.
This is usually the point where people begin thinking about talking with a Medicare advisor rather than trying to sort through every plan and rule on their own.
If you want to make it easy, just reach out and talk with us. We can answer your questions personally, look at what you’re currently doing, and help you understand what options may make sense for your needs and budget.
If you’re looking for straight answers from an independent Medicare agent in St. Joseph, Stevensville, Bridgman, or the surrounding Southwest Michigan area, give us a call.
You don’t have to know whether Medicare Advantage or a Medicare Supplement is right for you before you call. That’s what the conversation is for.
Call Maple Valley Insurance Group and let’s talk about your Medicare options.
[Talk With a Medicare Advisor]
Call Maple Valley Insurance Group
269-244-3420Let’s have a conversation and see if we’re a good fit to help.
Frequently Asked Questions
Is a Medicare Supplement better than Medicare Advantage?
Not necessarily for everyone. Medicare Advantage can be an excellent option for people who prioritize a low monthly premium and are comfortable with their plan’s network and cost-sharing. A Medicare Supplement may be a better fit for someone who prioritizes provider freedom, nationwide portability, and predictable medical expenses.
Can I use my Medicare Supplement in Florida if I live in Michigan?
Yes. Original Medicare and a Medicare Supplement provide nationwide portability. As a general rule, you can see virtually any doctor or healthcare provider across the country who accepts Medicare.
Does a Medicare Supplement have a network?
Medicare Supplements do not operate like Medicare Advantage networks. With Original Medicare and a Medicare Supplement, you generally have the freedom to use Medicare-participating doctors and hospitals throughout the country.
Does Medicare Supplement cover chemotherapy?
Original Medicare covers medically necessary chemotherapy, and a Medicare Supplement can cover some or all of the Medicare cost-sharing depending on the specific Medigap plan. This is one reason people who are concerned about the financial impact of serious illness may consider a Medicare Supplement.
A $0 monthly premium does not mean that your healthcare is free. Medicare Advantage plans can have copayments, coinsurance, deductibles, and other cost-sharing when you receive medical care. Those costs are subject to the plan’s annual maximum out-of-pocket limit.
Do Medicare Supplements cover dental, vision, and hearing?
Original Medicare and Medicare Supplement plans generally do not cover routine dental, vision, and hearing services. If those benefits are important to you, you may want to consider separate coverage designed to help with those expenses.
Do you offer both Medicare Advantage and Medicare Supplement plans?
Yes. Maple Valley Insurance Group offers both Medicare Advantage and Medicare Supplement options. We can help you compare the two approaches and determine which type of Medicare coverage better fits your healthcare priorities and budget.
