Medicare Supplement vs. Medicare Advantage
Medicare Supplement vs. Medicare Advantage: What’s the Difference?
Choosing between a Medicare Supplement plan and a Medicare Advantage plan can be confusing. This guide breaks down the key differences so you can choose the plan that fits your needs.
What Is Medicare Supplement (Medigap)?
Medicare Supplement Insurance, also known as Medigap, is private insurance that helps cover the out-of-pocket costs not paid by Original Medicare (Parts A and B). These costs can include deductibles, coinsurance, and copayments.
- You must be enrolled in Original Medicare to purchase a Medigap plan.
- Plans are standardized and labeled A through N (except in MA, MN, and WI, which have their own rules).
- You can see any doctor or hospital that accepts Medicare—no network restrictions.
What Is Medicare Advantage?
Medicare Advantage (Part C) is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies approved by Medicare and often include additional benefits beyond Original Medicare.
- Includes Medicare Parts A and B, and most plans also include Part D (prescription drug coverage).
- May include benefits like dental, vision, hearing, or wellness programs (benefits vary by plan and location).
- Most plans have provider networks (HMO or PPO), and costs can vary depending on whether care is in-network or out-of-network.
Key Differences Between Medicare Supplement and Medicare Advantage
| Feature | Medicare Supplement (Medigap) | Medicare Advantage (Part C) |
|---|---|---|
| Provider Flexibility | Any doctor/hospital that accepts Medicare | Typically limited to plan’s network, some plans have out-of-network for higher cost |
| Prescription Drug Coverage | Not included (requires separate Part D) | Typically included |
| Monthly Premiums | Higher premiums | Low premiums (often $0) |
| Out-of-Pocket Costs | Lower, more predictable costs | Copays and coinsurance apply; has annual out-of-pocket limit |
| Extras such as fitness membership, dental, vision, hearing aids, over-the-counter allowance | Not included | Often include some or all of these extras |
Which Option Is Right for You?
There’s no one-size-fits-all answer. Consider your healthcare needs, budget, preferred doctors, and travel habits. A Medicare Supplement plan may work better for someone who wants broad access to providers, minimal out-of-pocket costs, and predictable costs. Medicare Advantage may appeal to those looking for all-in-one coverage with extra benefits and lower premiums.
Tip: Your choice may also depend on what’s available in your ZIP code and how each plan’s features align with your personal priorities.
Need Help Comparing Plans?
Contact Medicare Planning today and schedule time with a licensed Medicare insurance agent!