Medicare Supplements vs. Medicare Advantage

Once you’re enrolled in Original Medicare, you will have the option to add on a Medicare Supplement (Medigap) plan or enroll in a Medicare Advantage plan. While both of these options can provide much-needed coverage, you need to review the coverage offered with both options so you can make an accurate decision about the type of policy you need.

What are Medigap Plans?

Medigap plans are sold through private insurance companies and help pay for the out-of-pocket costs that are not covered under Original Medicare, which consists of Parts A and B. These plans will work alongside Original Medicare and cover costs such as:

  • Deductibles
  • Coinsurance
  • Copayments
  • Excess charges
  • Foreign travel emergencies
  • Blood transfusions

There are ten Medigap plans to choose from, which include Plans A, B, C, D, F, G, K, L, M, and N. Each of these plans provide their own coverage for the costs listed above, with the most basic coverage being offered by Plans A and B. Plans C, F, G, and N are considered to have the most comprehensive coverage. However, Plans C and F are the only plans to provide coverage for the Part B deductible and are not available to anyone who became eligible for Medicare on or after January 1, 2020.

What are Medicare Advantage Plans?

Medicare Advantage plans, or Part C, can be considered as alternatives to Original Medicare as they offer the same coverage. However, Medicare Advantage plans also include extra coverage that Original Medicare does not cover:

  • Prescription drug coverage
  • Dental, vision, and hearing coverage
  • Adult day-care services
  • Wellness programs
  • Nutrition programs
  • Fitness memberships
  • Transportation for doctor visits

 

There are five Medicare Advantage plans that you may qualify to enroll in, which include:

  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • PFFS (Private-Fee-For-Service)
  • SNPs (Special Needs Plans)
  • MSA (Medicare Medical Savings Account)

Similarities and Differences

To enroll in a Medigap plan or Medicare Advantage plan, you must first be enrolled in Original Medicare. This is one of the biggest similarities that these two options have. Both are also sold by private insurance companies, which makes the costs of each plan vary by location and company.

As for differences, there are several. Medicare Advantage plans will occasionally require their members to receive their healthcare with a provider listed within their network. Going outside of this network to receive care can result in you not receiving coverage from your plan and paying out-of-pocket. With a Medigap plan, you can visit any healthcare provider as long as they accept Medicare.

With a Medigap plan, you will have to pay the premium of your chosen plan along with your premium for Part B and if you have a premium with Part A, although most beneficiaries receive premium-free Part A. Typically, the more coverage you have through a Medigap plan, the higher the premium. With Medicare Advantage, you will typically pay nothing or at least a low monthly premium along with your Part B premium. However, Medicare Advantage will still have you pay copayments, coinsurance, and deductibles when you use services. These are costs that Medigap covers.

With a Medigap plan, you’ll also have to consider purchasing a Part D plan if you want prescription drug coverage. However, most Medicare Advantage plans already have this coverage included.

Need Help?

For more information about Medigap plans or Medicare Advantage plans available to you, give us a call today at 855-GO-AVILA and speak with one of our licensed agents. We will help you compare all your coverage options to find a plan that works for you.