Understanding the difference between a Medicare Advantage plan and a Medicare Supplement (also known as Medigap) plan can be confusing, especially if you are new to Medicare or considering making a change to your current coverage. In this article, we will provide a detailed explanation of each type of plan and how they differ, so you can make an informed decision about which one may be right for you.
What is Medicare Advantage?
Medicare Advantage is a type of health insurance plan that is offered by private insurance companies and approved by Medicare. It is an alternative to Original Medicare (Medicare Part A and Part B) and typically includes additional coverage for things like prescription drugs, vision, and dental care.
One of the main differences between Original Medicare and a Medicare Advantage plan is that with a Medicare Advantage plan, the private insurance company is responsible for covering your medical expenses, rather than the government. This means that the insurance company sets its own rules and determines which services and benefits are covered under the plan.
Some Medicare Advantage plans also offer additional benefits not covered by Original Medicare, such as routine hearing and vision exams, gym memberships, and transportation to medical appointments. It's important to note that not all Medicare Advantage plans offer the same benefits, so it's important to carefully review the plan's coverage before enrolling.
Another difference between Original Medicare and a Medicare Advantage plan is how you receive your care. With Original Medicare, you have the freedom to visit any doctor or hospital that accepts Medicare, as long as they provide the service you need. With a Medicare Advantage plan, you will typically be required to see providers within the plan's network, although some plans may offer out-of-network coverage for an additional cost.
Finally, it's important to note that if you enroll in a Medicare Advantage plan, you are still enrolled in Original Medicare, but you must use the plan's network of providers instead of Original Medicare.
What is a Medicare Supplement (Medigap) Plan?
A Medicare Supplement (Medigap) plan is a type of insurance that is designed to help cover some of the out-of-pocket expenses that are not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Like Medicare Advantage plans, Medigap plans are offered by private insurance companies, but they do not provide additional coverage beyond what is offered by Original Medicare.
There are several different types of Medigap plans available, each with a different set of benefits. The most comprehensive plans, such as Plan F and Plan G, cover most of the out-of-pocket expenses that are not covered by Original Medicare, while the less comprehensive plans may only cover a few of these expenses. It's important to carefully review the benefits of each plan to determine which one is right for you.
One of the main differences between a Medicare Advantage plan and a Medigap plan is that a Medigap plan only covers expenses that are not covered by Original Medicare, while a Medicare Advantage plan provides additional coverage beyond what is offered by Original Medicare. This means that if you enroll in a Medigap plan, you will still be responsible for paying your Part B premium, as well as any deductibles, copayments, and coinsurance required by Original Medicare.
Another difference between the two types of plans is that with a Medigap plan, you have the freedom to see any provider that accepts Medicare, as long as you receive the service that is covered by your plan. With a Medicare Advantage plan, you may be required to see providers within the plan's network, although some plans may offer out-of-network coverage for an additional cost.
Which is Right for You?
When deciding between a Medicare Advantage plan and a Medicare Supplement (Medigap) plan, it's important to consider your individual healthcare needs and budget.
If you are looking for a plan that offers additional coverage beyond what is provided by Original Medicare, such as prescription drugs or routine vision and dental care, a Medicare Advantage plan may be the right choice for you. It's important to carefully review the plan's coverage and network of providers to make sure it meets your needs.
If you are comfortable with Original Medicare and are primarily looking for a way to cover some of the out-of-pocket expenses that are not covered by Medicare, a Medigap plan may be a good option. Again, it's important to carefully review the benefits of each plan to determine which one is right for you.
It's also important to keep in mind that you can only enroll in a Medicare Advantage plan if you are already enrolled in Original Medicare, and you must pay any premiums required by the plan in addition to your Part B premium. With a Medigap plan, you must also be enrolled in Original Medicare, but the plan only covers expenses that are not covered by Medicare, and you are responsible for paying your Part B premium.
Summary
The main difference between a Medicare Advantage plan and a Medicare Supplement (Medigap) plan is that a Medicare Advantage plan provides additional coverage beyond what is offered by Original Medicare, while a Medigap plan only covers expenses that are not covered by Original Medicare. It's important to carefully consider your healthcare needs and budget when deciding which type of plan is right for you.
If you are interested in learning more about your options for Medicare coverage, click on the offers below to explore the different plans that are available in your area.
Updated January 18, 2023