Social Security Matters – Is Medicare Part A and B Backing Up My Medicare Advantage Plan?
Social Security Matters – Is Medicare Part A and B Backing Up My Medicare Advantage Plan?

Social Security Matters – Is Medicare Part A and B Backing Up My Medicare Advantage Plan?

By Rusty Gloor, National Social Security Advisor at the AMAC Foundation, the non-profit division of the Association of Mature American Citizens

Dear Rusty: I was told that I can use Medicare Part A and B as secondary coverage for my Medicare Advantage plan. Is it true? Signed: Astonished

Dear astonished: Many people do not understand how the different parts of Medicare work, and especially how or if “original Medicare” (Medicare part A and part B) interacts with a Medicare Advantage plan. If you now have a Medicare Advantage plan, it is the private insurance company that provides your plan that manages all of your health needs, instead of the federal government agency that runs Medicare (the federal agency is called the Centers for Medicare & Medicaid Services, or “CMS”).

Although you must pay Medicare Part A and Part B premiums to the federal government to obtain a Medicare Advantage plan, all of your health care is handled by the private Medicare Advantage plan provider and not by the government’s CMS agency. When you have an Advantage plan, Medicare Parts A and Part B do not serve as secondary coverage for your Advantage plan. You do not receive healthcare from either, because when you choose a Medicare Advantage plan, you opt out of CMS as the administrator of your healthcare needs.

Deciding whether to use “original Medicare” to manage your healthcare or use a Medicare Advantage plan is always a very personal choice. Medicare Advantage plans cover almost all of the medically necessary services that original Medicare covers, although you will generally need “in-network” providers to get full coverage. However, if you incur health expenses that are not covered by your Medicare Advantage plan, you will have to pay them yourself – Federal Medicare Parts A and Part B are not backup coverage for these uncovered health expenses. So what you were told is wrong – Medicare Part A and Part B do not serve as secondary coverage for your Medicare Advantage plan.

This article is for informational purposes only and does not represent legal or financial guidance. It presents statements and interpretations from AMAC Foundation staff, trained and accredited by the National Social Security Association (NSSA). NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity. To ask a question, visit our website (amacfoundation.org/programs/social-security-advisory) or email us at [email protected].

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