By Lindsay Engle<\/p>\nW<\/span><\/p>\n Because Medicare changes from year to year, you must understand all the different options and stay informed on any changes that could affect your coverage.<\/p>\n Do you know the differences between Medicare Advantage and medigap plans? Are you aware of the changes coming in 2020?<\/p>\n The following information might help you navigate the Medicare maze \u2026<\/p>\n Before choosing between a Medicare Advantage and medigap plan, you must know the differences between them.<\/p>\n There\u2019s a ton of hype around Medicare Advantage plans, which can easily misguide you.<\/p>\n The first difference between these two options is the monthly premium. Yes, Medicare Advantage plans come with a low or zero monthly premium. Medigap plans can cost anywhere between $50 to $300 a month, depending on the letter plan you choose.<\/p>\n Medicare Advantage plans are offered through private insurance companies. Medicare pays these private insurance companies to take on your risk, which is how they can afford to provide low premiums.<\/p>\n Additionally, Medicare Advantage plans have many out-of-pocket costs that medigap plans do not have.<\/p>\n Let\u2019s say you go to the doctor\u2019s office to get some tests done. You present your Medicare Advantage card, and the receptionist asks for a $40 copay up front.<\/p>\n Your doctor then sends you down the hall for additional tests. These tests include lab work and imaging. So far, you\u2019ve only spent $40 out of pocket for your visit that day.<\/p>\n Later that same month, you receive a bill from your Medicare Advantage plan carrier. The statement shows that you owe a $40 copay for both the lab work and imaging. Also, you owe coinsurance of $80 for the lab work and another $100 for imaging. Now your one visit has cost you $300 out of pocket.<\/p>\n There are many medigap plans to choose from that can reduce your out-of-pocket costs. In this example, I\u2019ll use the top medigap plans to compare to Medicare Advantage.<\/p>\n In the above scenario, if you had plan F, you would have zero out-of-pocket costs. You would not be billed for any copays or coinsurance at any point.<\/p>\n If you had plan G, you would pay zero out of pocket up front. The only additional out-of-pocket cost you would be billed for is the part B deductible if you have not met that deductible yet for the calendar year.<\/p>\n If you had plan N, you would pay a $20 copay at the time of your visit. Just as with plan G, the only additional out-of-pocket expense you may be billed for is the part B deductible if it has not been met yet.<\/p>\n The second most noticed difference is the network of doctors. Many find that their primary care physician is not within their Medicare Advantage plan\u2019s network of doctors. Because more than 800,000 physicians accept Medicare, this is rarely an issue with medigap plans.<\/p>\n The last difference is that Medicare Advantage plans are not standardized like medigap plans are. Carriers can set their premiums, copays, network of providers, pharmacy networks, drug formularies, and out-of-pocket maximums.<\/p>\n With medigap plans, the benefits will remain the same across all carriers. The only difference is the monthly premiums.<\/p>\n There are many more differences between Medicare Advantage compared with medigap plans so it\u2019s essential to weigh out all the pros and cons before choosing one over the other.<\/p>\n It\u2019s not that Medicare Advantage plans are a wrong choice; it\u2019s just that they might not be the right choice for you.<\/p>\n Now that we\u2019ve compared a few differences between these two options, let\u2019s review some changes you should know regarding Medicare in 2020.<\/p>\n The elimination of first dollar coverage plans has been a huge topic this year. Congress felt that beneficiaries enrolled in first dollar coverage plans were overusing their benefits since they didn\u2019t have to pay anything out of pocket.<\/p>\n Due to this, they decided to eliminate all first dollar coverage plans from the pool of options. However, this only affects beneficiaries who are not eligible for Medicare until 2020 or after.<\/p>\n First dollar coverage plans would include C, F, and high-deductible F. If you were eligible for Medicare before 2020, even if you never enrolled in a medigap plan, you can still join a first dollar coverage plan after 2020.<\/p>\n If you fall into the bucket of newly eligible, you won\u2019t be able to enroll in plan F. For beneficiaries considered newly eligible, the plan that they can get with the most coverage is now plan G.<\/p>\n Guaranteed Issue Plans<\/p>\n Due to the above Medicare Access and Children\u2019s Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) changes,<\/a> there has been a shift in which plans accept guaranteed issue rights.<\/p>\n For those who are considered non-newly eligible for Medicare, your guaranteed issue plans are plans A, B, C, F, high-deductible F, K, and L.<\/p>\n For those who are newly eligible, your guaranteed issue plans will be plans A, B, D, G, high-deductible G, K, and L.<\/p>\n Also, due to MACRA, a new high-deductible plan was introduced by the Centers for Medicare and Medicaid Services (CMS): high-deductible plan G.<\/p>\n High-deductible plan G will be available to every beneficiary, regardless of when you became eligible for Medicare.<\/p>\n The benefits between the standard plan G and the high-deductible version are the same. The only difference is the $2,340 deductible that you must meet before your coverage kicks in 100%.<\/p>\n This deductible significantly reduces the monthly premium, which is why beneficiaries find this option attractive.<\/p>\n Newly eligible individuals will be the only ones able to use guaranteed issue rights when enrolling. If you\u2019re non-newly eligible, you can still use your guaranteed issue rights to join high-deductible plan F, but not high-deductible plan G.<\/p>\n Every year around October, CMS announces any changes to part A and B premiums and deductibles.<\/p>\n Part A is premium-free for most beneficiaries. If you didn\u2019t pay into Medicare for enough quarters, your premium could be as much as $458 a month.<\/p>\n For inpatient services:\n\u2022 From day one to day 60, you\u2019ll pay $0 in daily coinsurance.\n\u2022 From days 61 to 90, you\u2019ll pay $352 in daily coinsurance.\n\u2022 From day 91 plus, you\u2019ll pay $704 in daily coinsurance.<\/p>\n The deductible for part A increased from $1,364 to $1,408 in 2020. That\u2019s an increase of $44.<\/p>\n For part B, the 2020 premium will be $144.60. That\u2019s an increase of $9.10 from 2019. The 2020 deductible increased from $185 to $198. That\u2019s a $13 increase from 2019.<\/p>\n As you can see, there are many factors to consider when choosing between a Medicare Advantage plan and a medigap plan. It\u2019s also important that you stay on top of yearly premium and deductible increases that will affect your out-of-pocket medical costs.<\/p>\n Navigating Your Medicare Choices in 2020<\/p>\n","protected":false},"author":3,"featured_media":10080,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[124,125],"tags":[],"class_list":["post-9971","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-spring-summer-2020","category-spring-summer-2020-columns"],"acf":[],"_links":{"self":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts\/9971","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/comments?post=9971"}],"version-history":[{"count":6,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts\/9971\/revisions"}],"predecessor-version":[{"id":10301,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/posts\/9971\/revisions\/10301"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/media\/10080"}],"wp:attachment":[{"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/media?parent=9971"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/categories?post=9971"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthyaging.net\/magazine\/wp-json\/wp\/v2\/tags?post=9971"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}hat\u2019s your Medicare IQ?<\/h3>\n
Differences Between Medicare Advantage and Medigap Plans<\/h3>\n
Example<\/h4>\n
Elimination of First Dollar Coverage Plans<\/h3>\n
Introduction of High-Deductible Plan G<\/h3>\n
Medicare Increase for 2020<\/h3>\n
Part A<\/h4>\n
Part B<\/h4>\n
Wrapping It Up<\/h3>\n
Lindsay Engle is a Medicare expert at MedicareFAQ.<\/a><\/h5>\n","protected":false},"excerpt":{"rendered":"