Latest / Smart Coverage. Real Advice.: Medicare / What Does Medicare.gov Say About Comparing Medicare Advantage and Medigap in Tennessee?
Transcript
- Tanya: How much should Medicare Advantage star ratings matter when choosing coverage in Tennessee? If you’ve seen those stars but aren’t sure what they mean, keep listening. Tanya: Welcome to Smart Coverage. Real Advice., the insurance podcast from The Jordan Insurance Agency. I'm Tanya, your host, and I'm here with Billy Jordan, a licensed insurance agent and the president of The Jordan Insurance Agency. Billy: Glad to be here, Tanya. A quick disclaimer: we're not affiliated with or endorsed by Medicare or any government agency, and this is general education, not advice for your situation. Now, let's get into it. Tanya: So, Billy, when someone is looking at Medicare Advantage plans in Tennessee, they’ll often see these star ratings next to each plan. According to medicare.gov, what are those ratings supposed to tell us? Billy: Actually, Tanya, the medicare.gov article titled "Your coverage options" doesn’t mention star ratings for Medicare Advantage plans. It focuses on explaining the main choices for Medicare coverage, like Original Medicare and Medicare Advantage, and what each option includes. So, if you’re looking for information about star ratings specifically, you won’t find it in that article. Tanya: That’s good to know. So what does medicare.gov say about what people in Tennessee should look at when comparing Medicare Advantage and other coverage options? Billy: According to medicare.gov, your first big decision is choosing between Original Medicare and Medicare Advantage. With Original Medicare, you can go to any doctor or hospital that takes Medicare, anywhere in the U.S. You pay as you go, and you can add a drug plan or a Medigap policy if you want extra coverage for out-of-pocket costs. Medigap policies are standardized, so the benefits are the same no matter which company you buy from—only the price changes. But you can’t use Medigap with Medicare Advantage. So, it’s important to understand how these options fit together. The mistake I see is folks trying to combine things that can’t be combined, like picking a Medicare Advantage plan and then trying to add a Medigap policy. The two don’t work together. Tanya: And if someone picks Original Medicare, what are some reasons they might want to add a Medigap policy or a drug plan? Billy: Good question. If you go with Original Medicare, it only covers hospital and medical insurance—Parts A and B. It doesn’t include most prescription drugs or help with all your out-of-pocket costs. That’s where a Part D drug plan or a Medigap policy comes in. Medigap helps cover things like copays and deductibles, while Part D covers prescriptions. But you’ve got to sign up at the right time, or you might pay more or even miss your chance. I’ve seen people wait too long to add a Medigap policy, and then they either can’t get it or end up paying a lot more. Tanya: Are there any other factors or options folks should be aware of when comparing Medicare coverage? Billy: Yes. You may also have other coverage, like employer or union, military, or veterans’ benefits. Medicare.gov says you should learn how Medicare works with other insurance. And if you need help with your choices, you can contact your local State Health Insurance Assistance Program, or SHIP. They offer free, personalized counseling and aren’t connected to any insurance company or health plan. That can be a great resource if you want to talk through your options in detail and get unbiased help. Tanya: Three things to remember. One, medicare.gov doesn’t cover star ratings for Medicare Advantage plans in its "Your coverage options" article. Two, always check your doctors, prescriptions, and extra benefits before choosing a plan. Three, make sure you understand how Original Medicare, Medicare Advantage, Medigap, and Part D work together—because not all of them can be combined. Tanya: For a personalized look at your situation, book a free thirty-minute chat with Billy and his team at thejordaninsuranceagency.com/podcast. Billy: I'm Billy Jordan with The Jordan Insurance Agency. Until next time, take care. Tanya: Thanks for listening to Smart Coverage. Real Advice. from The Jordan Insurance Agency.