The difference between traditional (as opposed to Original) fee for service Medicare plus a private supplement from a former employer or bought individually and Original Medicare plus almost all public Part C health plans (you have to have Original Medicare to select a Part C plan) is the same difference most people not on Medicare face:
- uncoordinated care from any provider that accepts the insurance vs.
- managed care from a usually geographically based network of providers
Despite constant charges by the left-wing media, the choice has nothing to do with your healthier or not. In fact, since managed care is used disproportionately by minorities and the poor, it is likely -- but not provable -- that Part C beneficiares are not healthier than private Medigap beneficiaries.
By far the major advantage of public Part C Medicare health plans in the United States is that they include annual out of pocket health-care (not drug1) spending limits (averaging around $5000 in 2014 with a max of $6700). Original Medicare Parts A and B do not include such a limit and also have lifetime limits on benefits it will pay to acute care and skilled nursing facilities. Only the most expensive private Medigap plans include such an OOP limit. Most private supplemental plans extend but do not eliminate the lifetime limits (but an annual OOP limit almost eliminates the lifetime limits).
But such protective private supplemental plans are not available in all states. In Massachusetts, where I live, the only way I can get annual OOP protection and eliminate the lifetime limit is via Part C. Such protection is basically the reason one buys insurance. (But I still would not choose Part C if my doctor did not accept it.)
1The Part C annual OOP limit is on healthcare spending. The limits on self-administered drug costs follow the Part D rules of four phases of spending: deductible, initial, gap, and catastrophic. Most plans do not have a deductible and only a very small percentage of all Medicare beneficiaries reach the third so-called gap phase. Only 1% of all Part D beneficiaries reach the catastrophic level. If there were statistics on whether Part C beneficiaries reached the gap sooner than all Medicare beneficiaries, it might indicate if
they are healthier as a group or not. The current indications is that they are less healthy because they have higher risk scores on average (this would make sense because they are disproportionately poorer than all Medicare beneficiaries). There is also an allegation -- not supported by CMS and the GAO -- that these risk scores are intentionally inflated by insurers.
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