Comparing Medicare Advantage Plans vs Medicare Supplements (Medigap)

A Medicare Supplement (Medigap) plan essentially covers the gaps in Original Medicare by paying for deductibles, copays, and coinsurance, allowing you to use any Medicare-approved provider, while a Medicare Advantage plan bundles Original Medicare with additional benefits like prescription drugs, vision, and dental care, but usually requires you to stay within a network of providers to access the full range of coverage; Medigap plans typically have higher monthly premiums compared to Advantage plans, but offer more provider flexibility. 

Key differences: 

Provider Network:

With Medigap, you can use any Medicare-approved provider, while Medicare Advantage plans usually limit you to a specific network of doctors and hospitals. 

Extra Benefits:

Medigap Plans only cover what Original Medicare doesn't, while Advantage plans often include extra benefits like prescription drugs, vision, dental, and wellness programs. 

-  NOTE:  For Medigap plans, just need to add a Part D (Rx) Plan which can be as low as $0/month.  Other benefits like Dental/Vision are also available with separate plans/memberships.

Premiums:

Medicare Advantage plans often have lower monthly premiums compared to Medigap plans. 

Out-of-pocket costs:

While Medigap may have higher premiums, it can sometimes result in lower out-of-pocket costs due to the ability to use any provider with rare copays. 

Who might choose a Medigap plan:

• People who value flexibility in choosing providers and want to avoid network restrictions.
• Individuals who travel frequently and need access to a wide range of healthcare providers. 
• Those who prefer a simpler coverage structure with consistent out-of-pocket costs. 
• Some plans offer limited coverage outside the United States.

Who might choose a Medicare Advantage plan: 

• People looking for potentially lower monthly premiums and may want additional benefits like vision, dental & hearing included. 
• Individuals comfortable with using a network of providers and managing their care within that network. 
• Those seeking comprehensive coverage with potentially lower out-of-pocket costs if they utilize preventive services and manage chronic conditions well
• There are SNP plans for those on Medicaid or have a Chronic Condition.