Medicare Advantage vs. Medicare Supplement (Medigap) Plans

If you are new to Medicare or are looking to make a change in your plans, you may wonder which plan is right for you. When deciding which plan to enroll in, your first step should be to decide between a Medicare Advantage plan and a Medicare Supplement plan. Understanding which plan type is right for you is essential when enrolling in coverage.

There are many differences between Medicare Advantage vs. Medicare Supplement plans. So, it is crucial to research and thoroughly understand how each plan type works before deciding. You are not alone in your research, and we are here to help.

What Are Medicare Advantage Plans?

Private insurance companies offer and administer Medicare Advantage plans. These plans take on the role of primary coverage for Medicare beneficiaries. Medicare pays these private insurance companies to take on your risk.

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These plans can also come with a regional network of doctors and hospitals, meaning coverage from the plan will not travel with you. Additionally, your current doctor may not accept the plan as coverage.

Medicare Advantage plans must offer the same benefits you get from Original Medicare and can also include additional benefits. However, these other benefits vary from plan to plan. When you enroll in a Medicare Advantage plan, you agree to pay higher out-of-pocket costs through cost-sharing in exchange for a lower monthly premium.

Often, Medicare Advantage plans include prescription drug coverage. While not all plans offer drug coverage, most Medicare Advantage HMO and PPO plans include this additional benefit.

What Are Medicare Supplement (Medigap) Plans?

Medicare Supplement (Medigap) plans are also offered through private insurance companies. Yet, they must include the same coverage regardless of carrier. Medicare Supplement plans pick up the remaining cost-sharing for which you would typically be responsible with only Original Medicare.

Medicare Supplement plans give you the ability to predict your costs. Because all plans have the same benefits, you will always know your out-of-pocket limits. When enrolled in a Medicare Supplement plan, there is no network of doctors to which you must adhere.

You can receive coverage from any doctor or hospital that accepts Original Medicare across all U.S. states and territories.

Additionally, some Medigap plans – such as Medicare Supplement Plan G – cover excess charges in states that allow them. If the doctor does not accept Medicare assignment, you will not need to pay extra because your Medigap plan protects you.

What is the Difference Between Medicare Advantage and Medicare Supplements?

While Medicare Supplement plans pay secondary to Original Medicare, Medicare Advantage plans become your primary source of coverage when you enroll.

Medicare pays a set amount to the carrier for the Medicare Advantage plan in which you enroll to take on your coverage needs for the calendar year.

Those new to Medicare may notice a considerable amount of Medicare Advantage plan promotion through advertisements and little to no promotion of Medicare Supplement plans.

This is due to the difference in carrier profit margins between Medicare Advantage and Medicare Supplement plans.

Depending on your lifestyle, budget, and medical coverage needs, one plan type will suit your needs more.

Medicare Supplement vs. Medicare Advantage Pros and Cons

There are several differences between Medicare Advantage vs. Medicare Supplement plans. A Medicare Advantage plan (Medicare Part C) is structured as an all-in-one option with low monthly premiums.

Medicare Supplement plans offer additional coverage to Original Medicare with low to no out-of-pocket costs. The chart below reviews the pros and cons of Medicare Advantage and Medicare Supplement plans.

When it comes to Medicare Advantage vs. Medicare Supplements, the biggest complaint we hear from our clients is that they are unable to accurately predict their out-of-pocket costs when enrolled in a Medicare Advantage plan.

On the other hand, the biggest compliment we hear from clients is regarding Medicare Supplement plans. Most beneficiaries stick with Medicare Supplement plans because of their ease and reliability. The option to go to any doctor that accepts Original Medicare is the cherry on top of Medicare Supplement plans.

Which is Better Medicare Advantage or Medicare Supplement?

Medicare does not offer a one-size-fits-all plan. So, the best policy for you is the policy that best meets your healthcare needs.

Medicare Supplement plans are the best option if you want complete reassurance and predictability with your healthcare but are comfortable paying higher premiums in exchange for lower out-of-pocket costs.

In contrast, Medicare Advantage plans are the best option if you hope to save on monthly premiums and receive additional benefits while accepting responsibility for additional out-of-pocket costs at the doctor’s office.

For overall ease and reliability, our recommendation is always Medicare Supplement plans. However, we know that may not work for everyone. Our goal is to provide you with your best options regardless of plan type.

How Do I Choose Between Medicare Advantage and Medicare Supplement Plans?

Do you want predictable costs, the freedom to choose any doctor, avoid referrals, and peace of mind while traveling? If you answered yes, you are looking for a Medicare Supplement plan.

Are you comfortable with unpredictable copayments, strict doctor networks, and referrals in exchange for a lower monthly premium and additional benefits? If your answer is yes, Medicare Advantage could work for you.

The best part about working with agents is that no matter which option you choose, we make sure it is the best for you. Perhaps you are already thinking about making the switch from a Medicare Advantage to a Medicare Supplement plan, or the other way around.

Give us a call at the number above to learn about your best plan options today! Or, fill out an online rate form to connect with an agent today!

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