Which is Better?
Traditional Medicare or Advantage
This one seemingly simple choice is such a pain in the keyster.
I'm going to give you the short and simple. With traditional Medicare and a seperate supplement (Medi-gap), a stand alone part D plan, and a dental plan you will pay more each month (naturally there are exceptions). What you are buying is lower out-of-pocket costs and more control over your healthcare (again, a generallity, but it is generally true).
One thing you need to understand right up front is that commissions do not affect what you pay. If you purchase through an agent or go direct with the company the price is the same. Another thing you need to understand up front is that the first year commissions on Medicare Advantage plans are significantly higher than Medicare Supplements.
Why I Often Recommend Traditional Medicare with a Supplement
In a word, it's about control. Far too often insurance companies get in-between the doctor and patient. With traditional Medicare and a Medicare Supplement you and your doctor have more control over your healthcare.
While there are some prior approvals with Medicare they are much more rare than with Medicare Advantage. If the treatment is related to the diagnosis then generally Medicare will approve the treatment. There are standards of care and all they want to do is to make sure that those standards are being followed. They also want to limit fraud, waste, and abuse.
With Medicare Advantage there are more prior approvals (this is when the doctor says, "we need to do XYZ, but we have to go see what your insurance will approve). When the Advantage plan company is doing their prior approvals they are often looking for the least expensive option that meets the standard of care or they may "fight" the diagnosis and try to limit care in the first place. There are exceptions and if you want my personal opinion I think Devoted is your best choice followed by the Blue Cross organizations.
We'll discuss both Traditional Medicare and Medicare Advantage when we talk at our first appointment.
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Why I Often Recommend Devoted
One thing I’ve noticed over the years is that with Medicare Advantage plans customer service matters and how the companies approach prior authorization matters.
Devoted may not be a name you are familiar with yet, but let me tell you why you will be eventually. First, all their customer service is based in America. Not the Phillipines, not India, not Costa Rica...all nice places that have great people, but sometimes it is hard to understand those people.
The other thing about that American based customer service is that the person who answers the phone can answer almost any question. Devoted is a fairly new company and it is founded by two brothers that made their fortunes in software for electronic medical records. They made all new software for Devoted...one piece of software. Most companies have 4-6 different software platforms for different functions...hence you have to be transferred around to different departments because everyone doesn't have access to all the software.
The other thing about Devoted is they don't overuse the prior approval process. When their decisions are appealed Devoted is overturned less than 1% of the time. Compare that with United Healthcare where they get overturned 85% of the time. This is a huge, huge deal people. IF you are going with Medicare Advantage I highly reocmmend Devoted for this reason alone.
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My goal is simple
when we finish our conversation, you should feel informed, confident, and at ease about your next step. By filling out the form below you are giving me (Andrew Bennett a licensed insurance agent) permission to contact you.
Why do so many people choose Medicare Advantage vs Traditional Medicare
In a word, "cost." Most Medicare Advantage Plans have at least one, but generally more where the monthly cost is $0. They also add extra benefits like dental, vision, and gym member benefits to those plans. Medicare Advantage Plans are just plain less money on a monthly basis.
Here's the skinny though. Those extra benefits are not widely used. I've got plenty of Medicare Advantage Enrollees that still have a seperate dental plan because their dentist doesn't take the insurance from the Advantage plan.
I always tell people, "You buy insurance for the insurance, not the extra's".
By the time we finish, you’ll know what fits and why. There’s absolutely no pressure, just clear answers about your Medicare choices.
Understanding Your Medicare Choices
When you first look at Medicare, it can seem confusing with Parts A, B, C, and D, each with different rules and coverage. Once we review it in plain English, it quickly starts to make sense.
Original Medicare
(Parts A and B)
Medicare Parts A and B are the foundation. The help covers hospital care, doctor visits, and some basic medical needs. But it’s important to note that they don’t cover everything. With Original Medicare, there are gaps for things like prescriptions, dental care, and vision care. The biggest thing missing from traditional Medicare though is an Out-of-Pocket Maximum.
Medicare Supplement
(Medigap)
That’s where Medicare supplements come in. These supplements give your Medicare an out-of-pocket Maximum. These plans are great. They minimize your cost when you get care, but you pay a monthly premium for that benefit. If you prefer to keep the same coverage year after year and can handle the monthly premium then this might be the option for you.
Medicare Advantage
(Part C)
A Medicare Advantage plan bundles everything into one plan. This type of plan offers hospital, medical, and often dental, vision, and hearing coverage. Many people like the simplicity of having one plan instead of multiple plans you have with traditional medicare (i.e. A & B, Medi-gap, dental, and vision…that’s a lot of cards to keep in your wallet).
Prescription Drug Plans
(Part D)
If you stay with Original Medicare and a Medicare Supplement, you’ll still need a separate PDP (Prescription Drug Plan) to cover your prescriptions.
Each option has its pros and cons. The right choice depends on your health, budget, and comfort with networks. My job is to walk you through those details and compare plans from all the top carriers.
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In the Which is Best Traditional Medicare vs Medicare Advantage I am squarely on the Traditional Medicare Side.
That being said nearly half my clients still go with Advantage nplans and I work with a lot of them...Aetna, BlueCross/BlueShield of Tennessee, Cigna, Devoted, Humana, UnitedHealthcare, and Wellcare. Remember with these plans you have to stay in-network, your benefits change year to year (generally minor changes...but still), and your out-of-pocket costs tend to be higher.
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If you are turning 65 in a few months then don't wait
People generally contact me 3-6 months before the month of their birthdate. That gives us time to have that first educational appointment. It gives you time to apply for Medicare if you need to. It also gives you time to decide on what type of plan fits you best.
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Let’s Talk About Your Coverage
You don’t need to guess about your Medicare plan. If you’d like some help sorting it out, just submit your name and number below, and I’ll give you a call. We’ll go over what you have, what’s changing, and what might fit better.
You won’t get a sales pitch from me. We’ll just have a real discussion about your Medicare Advantage, Medi-Gap, or Medicare Supplement options: no pressure, no cost, no strings attached. By filling out the form below you are giving me (Andrew Bennett a licensed insurance agent) permission to contact you.
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I only work with people
in Tennessee, Georgia, and Virginia. We’ll focus on the Medicare Advantage, Medigap, and PDP (Prescription Drug Plan) options available where you live. If you’d prefer to reach Medicare directly, you can always visit Medicare.gov or call 1-800-MEDICARE to see every plan in your area.
I’m here if you’d like personal help sorting through the details. Sometimes a short chat saves a lot of confusion.
If you’d rather call me directly, I’m at 865.712.5711. I’m happy to talk whenever it’s convenient for you.