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Comparing Benefits of Traditional Medicare and Medicare Advantage Plans

Two key factors in evaluating different Medicare options are coverage and cost, according to Gada.

Coverage
Traditional Medicare includes Part A (hospital) and Part B (medical). Yet, because traditional Medicare coverage is limited, many people also pay more to get supplement insurance (Medigap) and prescription drug coverage (Part D) to help offset high out-of-pocket expenses.

However, people with disabilities who choose traditional Medicare coverage often are unpleasantly surprised to learn they cannot take advantage of Medigap because pre-existing conditions frequently are excluded or have limited coverage.

In fact, 24 states also now severely limit Medicare supplement insurance options. In Texas, for example, people who are not yet 65 are limited as a group to getting only one Medicare supplement plan. This is the most limited standardized Medicare supplement plan of the 12 offered in Texas and provides only basic benefits. Meanwhile in 2008, Texans have 387 potential Medicare Advantage plans to choose from, 20 of which enroll only people with chronic or disabling conditions.

"An unfortunate irony is that medical issues related to the very disability that made them eligible for Medicare may also make them ineligible for supplemental insurance," said Gada. "They find themselves with just basic coverage under Medicare and mounting, unplanned-for out-of-pocket expenses they can't afford on SSDI income."