Medigap Vs Medicare Advantage Plans

If you’ve been on Medicare for a while but feel you are missing out on some benefits, you probably should look into your plan. There are several new supplements on the market to help with your Medicare including Medigap and Medicare Advantage (MA).  That said, you cannot use Medigap and Medicare Advantage together. You have to decide which plan will work best for you. We are here to go over the two plans so you can make a smart choice.

Explaining Medigap

Medigap is best known as Medicare Supplement Insurance which offers additional coverages for your Medicare plan. Medigap fills in empty spots in your insurance such as out-of-pocket expenses that Medicare will not cover.

Medigap plans are provided by private insurance companies. They are licensed by the state in order to provide this insurance.  There are different kinds of Medigap plans which provide different coverages.  Even though the plans can vary from one state to another, the majority of the states in the U.S. offer 10 different kinds of coverage.  Many people used to choose Medigap Plan F which has the largest range of coverage out of the various plans. However, Plans N and G are now becoming more popular.  Medicare Plan N vs Plan G frequently provides the most value when comparing all the plans. The best plan will be determined by your coverage goals and budget.

What Is Medicare Advantage?

Medicare Advantage is often referred to as Plan C or MA and offers several alternatives to Original Medicare.  Medicare Advantage means you are still on Medicare but it’s provided by private insurance companies that have been approved by Medicare. Unlike other plans, MA is funded by the government. Also, most Advantage plans offer Medicare Plan D which covers your prescriptions (also known as MAPD). If for some reason your MA plan does not cover prescriptions, you can sign up for a separate Medicare drug plan.

Both Medigap and Medicare Advantage can provide you much needed coverage that Original Medicare may not cover completely. There are differences that you should be aware of when choosing the best plan for you.

Prices

There is one big difference between Medigap and Medicare Advantage. Medigap does have higher premiums than Medicare Advantage. But, Medicare Advantage offers fewer expenses than Medigap which means you could have more out-of-pocket expenses. Just read through their plans and choose the one that works best for you and your lifestyle.

Choosing Your Doctors

This is a simple decision when choosing Medigap or Medicare Advantage.  Medicare Advantage has a very limited selection of physicians and facilities in its network.  There are cases when Medicare Advantage does not cover out-of-network physicians at all. Medigap provides coverage with any physician that accepts Medicare.

The Location

The decision can depend on where you are located. If you live in a certain state and rarely travel, Medicare Advantage might be best for you. If you live in more than one state over the year or travel a lot, then Medigap will probably be a better choice. Medicare Advantage plans usually only cover one exclusive region and don’t offer coverage when traveling internationally.  As for Medigap, you have coverage in all 50 states, and some plans provide some coverage when you travel outside the U.S.

Medigap Benefits

Medigap fills in the coverage gaps of Medicare Parts A and B. It provides more comprehensive options for someone who is insured. It covers most out-of-pocket expenses in the Original Medicare plan.

In general, having more comprehensive coverage, one of the best benefits is the cost. Even though premiums are higher than Medicare Advantage, the premiums result in fewer to no out-of-pocket costs.

Medigap has more flexibility when it comes to the physician network. In general, any physician or facility that accepts Medicare is covered by Medigap which is in stark contrast to Medicare Advantage.

Another advantage of Medigap, there is little to no effort in filling out the claim form. There is literally no paperwork to deal with. Checks are automatically made out to the provider and facilities after Medicare pays their portion.

Medicare Advantage Benefits

Medicare Advantage is an extension to Medicare parts A and B and offers more coverage than the original Medicare. This is popular because it replaces the original Medicare plan while staying affordable. It usually has lower premiums than Medigap which makes it attractive if you do not use it all the time. For many plans, when you hit the maximum out-of-pocket costs, the plan will cover you for the remainder of the year.

Another popular choice, for choosing Medicare Advantage, enrollment is really easy. You will be qualified for Medicare Advantage if you qualify for the original medicare plan and enrollment takes place every year.

Most Medicare Advantage plans cover prescriptions, known as Part D. Medigap, on the other hand, does not offer prescription coverage. This means you will have to buy a prescription drug plan (Part D) separately.

Author Bio

Michael Quinn

Hi, I’m Michael, the co-founder and editor of REMEDIGAP – a website devoted to Medicare education. As a licensed independent insurance broker in 47 states, we help thousands of Americans understand their Medicare options.

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