Medicare advantage vs. Medigap

Is It Better to Have Medicare Advantage or Medigap?

Medicare beneficiaries that have an Original Medicare plan may find gaps in their coverage they want to cover. Fortunately, there are options to help you supplement your coverage: Medicare Advantage (Medicare Part C) and Medicare Supplements (Medigap). However, both of these plans can’t be used together, and they offer different coverage. The best option depends on your particular needs.

Medicare Supplement is a supplemental insurance plan for beneficiaries who have Original Medicare, while Medicare Advantage (MA) is an alternative health insurance plan to Original Medicare. Let’s look at the coverage options for both Medigap and Medicare Advantage plans.

Medigap

Medigap plans supplement Original Medicare by filling the coverage gaps and offering more comprehensive options for the beneficiary. Depending on the Medigap plan you select, it can cover most, if not all, of Medicare Part A and Part B out-of-pocket costs. In addition to having comprehensive coverage, Medigap is also cost-effective. While its premiums can be higher than those of MA, it offers little to no out-of-pocket costs.

Medicare Supplement also provides a great deal of flexibility when it comes to provider networks. Generally, any clinic or doctor that accepts Medicare also accepts Medicare Supplements. This is in contrast to the more limited network provided by Medicare Part C. Also, Medigap makes it effortless to file a claim. There is nearly no paperwork to deal with and providers receive their checks automatically after Medicare covers its share of the bill.

Medicare Advantage

Medicare Advantage is an alternative to Original Medicare and offers more coverage. Medicare Advantage is very popular because while it replaces Original Medicare and provides more coverage, it still remains affordable. The plan usually has much lower premiums than Medicare Supplements, making it an attractive health insurance option.

Most of these plans also include extra benefits like prescription drug coverage, dental coverage, hearing coverage, and vision coverage. However, Medicare Supplements don’t provide these additional benefits, so you must purchase a standalone insurance plan that does if you want this extra coverage.

How Do You Decide Which is Better?

Ultimately, the decision is up to you. There isn’t technically a right or wrong answer as it’s all up to the coverage you need and the budget you have.

For those with Original Medicare who need help covering costs such as deductibles, coinsurance, or copayments, a Medicare Supplement plan may be an option to consider. There are a variety of supplement plans to choose from, each with its own percentage of coverage, so you can view each plan and determine if you need a basic form of coverage (Medicare Supplement Plans A or B) or something more comprehensive (Medicare Supplement Plans F, G, or N).

If you prefer the coverage you have with Original Medicare but want the additional benefits that can be included with Part C, a Medicare Advantage Plan might be something to consider. Like Medicare Supplements, there are multiple Medicare Advantage Plans that you can qualify and enroll for, such as HMO Plans or PPO Plans.

Get Help Choosing the Right Plan

If you are still unsure of the right plan for you, contact Turning 65 Solutions to speak with an experienced Medicare expert. At Turning 65 Solutions, we will help you compare the benefits and costs of each plan in relation to your individual health care needs and budget.

Turning 65 Solutions can help you plan for the future.