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

If you live in the Miami 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 Miami, 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:  Ask an advocate to work for you.  "If you receive a large bill for services, following an ER visit or surgery, for example, and you don't understand how to read it, hire a medical billing advocate to assist you," suggests Ruth Linden, founder of Tree of Life Advocates in San Francisco.  "She or he will not charge you if everything is in order.  On the other hand, if errors or a questionable charge is found, the typical billing advocate may charge you one-third to one-half of the amount they save you.  Your cost savings could run into thousands of dollars."  This can be especially important if you're dealing with a complex medical issue that requires significant, and expensive care.  Some insurance companies have even begun offering their own advocates, such as UnitedHealthcare's Advocate4Me program, which provides a single point of contact with an expert who can help you understand your coverage and find the help you need.

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 Miami,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.




University of Miami hospital 1400 NW 12th Ave Miami, FL 33136 Telephone: (305) 325-5511 Plus Code: QQQM+8G Miami, Florida






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 Miami 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:  If you just can't find a plan that is both within your price range and contains the health benefits you need, an alternative health plan might be what you need.  If individual plans are too expensive, offer too much, or offer too little - don't think you have nowhere to go.  There are low-cost health insurance alternatives, like short term health insurance and health care sharing plans.
Each plan has its own terms and limitations, so be sure to check the official plan documents to understand how each plan works.






Other articles:  Is Short-Term Health Insurance Right For You?
Finding Short-Term Health Insurance.
The First 3 Steps in Acquiring Medicare Supplement Insurance Coverage in Florida
Finding Health Insurance in Miami, Florida - 3 Important Steps
Resources