How To Choose Between Medicare Advantage and Medigap: Which Is Right for You?

Medicare Advantage and Medigap plans offer valuable financial protection, but cater to different needs and preferences. Understanding the key differences between these plans can help you make an informed decision to suit your health care requirements.

Medicare is a federal health insurance program primarily for people over age 65 and those with certain disabilities. It may consist of the following:

• Part A (hospital insurance)

• Part B (medical insurance)

• Part C (Medicare Advantage)

• Part D (prescription drug coverage)

Understanding Medicare Advantage

Medicare Advantage is an alternative to Original Medicare (i.e., Parts A and B) provided by private insurance companies. These plans bundle Parts A and Part B, often including additional benefits, such as prescription drug coverage and dental, vision and hearing services.

Medicare Advantage plans typically operate within a network of doctors and hospitals, so you may need to choose health care providers within this network to receive full benefits. This can be a limitation if you prefer a wider choice of providers or travel frequently and need coverage in different locations. Additionally, while Medicare Advantage plans often have lower monthly premiums than Medigap, they may come with higher out-of-pocket costs for certain services.

Exploring Medigap Plans

Medigap, also known as Medicare Supplement Insurance, is designed to work alongside Original Medicare by covering additional out-of-pocket costs, such as copayments, coinsurance and deductibles. The benefits of each plan type are consistent across different insurance companies.

Unlike Medicare Advantage plans, Medigap plans do not have network restrictions, allowing you to see any doctor or specialist who accepts Medicare. This can be particularly beneficial if you have specific health care providers you prefer or require care from specialists who may not be in a Medicare Advantage network.

Medigap plans generally provide more predictable out-of-pocket costs, which can be advantageous for budgeting your health care expenses. It’s important to note that Medigap plans do not include prescription drug coverage, so you may need to enroll in a separate Part D plan for your medication needs.

Contact Us

Contact Medicare Line to learn about Medicare Advantage and Medigap options near you.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.