Medicare Advantage and Medicare Supplement Insurance from Medical Mutual include different benefits. If you’re not sure what type of coverage fits your lifestyle and healthcare needs, use the overview below to see what’s covered.

  Medicare Advantage (Part C)   Medicare Supplement Insurance (Medigap)
Description  Medicare Advantage plans provide coverage for Part A (hospital) and Part B (medical), with many plans also including Part D (prescription drug) coverage. These plans provide additional benefits that Original Medicare does not include, such as dental, vision and hearing. Medicare Advantage plans also offer lower out-of-pocket costs than Original Medicare. Medicare Supplement plans are health plans that work in conjunction with Original Medicare and reinforce its coverage by paying for expenses Original Medicare does not cover, like copays, coinsurance and deductibles.
Is Prescription Drug (Part D) Included?  Yes

Our Medicare Advantage plans include Part D prescription drug coverage.
No

In order to get prescription drug coverage, you must buy a Part D plan separately.
Are Additional Benefits Included?  Yes

Our Medicare Advantage plans offer additional health and wellness benefits (including the SilverSneakers® fitness program) as well as dental, vision and hearing coverage.
No

However, Medical Mutual provides the SilverSneakers® fitness program at no additional cost to you.*

Some insurers, like Medical Mutual, also provide SilverSneakers® with their Medicare Supplement plans at no additional cost to you.*
How Do I Know I Am Eligible to Enroll? You must have Medicare Part A and Part B, and continue to pay the Part B premium. You have guaranteed acceptance as long as you live in the service area** (this is automatically verified when requesting a quote). You must have Medicare Part A and Part B, continue to pay the Part B premium and live in Ohio at least six months of the year. Applicants who enroll during the Initial Open Enrollment Period will have guaranteed acceptance.
What Doctors and Hospitals Can I Visit?  You must use providers in the plan’s network (except in an emergency). Different types of plans have different networks:

HMO plans: You can only visit in-network providers and referrals may be required for certain services or specialists.

PPO plans: You could visit any provider in or out of network, but going to out-of-network providers will cost you more out of pocket.
You can visit any provider who accepts Medicare patients, anywhere in U.S. In addition, some plans cover medical care when traveling outside of the United States.
Is This Plan Renewable?  Yes, you will remain in a plan unless you choose to disenroll. However, the plan’s benefits may change from year to year. Yes, you have guaranteed renewal as long as you pay your premium and your application information is correct. Your benefits do not change from year to year; however, the Centers for Medicare and Medicaid (CMS) may update the benefit amounts.
Who Is This Plan Best For?  • You prefer simplified coverage under one plan

• You are looking for affordable doctor visits, with little or no copays for preventive care.

• You prefer paying little or no monthly premiums but may have higher out-of-pocket expenses.
• You frequently travel outside of Ohio, so you need the flexibility of going to any doctor or hospital that accepts Medicare

• You think you need high-cost or frequent care
Learn More  Medicare Advantage Plans

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Medicare Supplement Plans

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*Medical Mutual provides SilverSneakers membership at no extra cost to you. SilverSneakers is an additional insured member service apart from the Medical Mutual Medicare Supplement Insurance plan benefits. SilverSneakers is provided by a third party and you can choose to take or not take the service.

Page last updated on 6/3/2021
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