Medicare Supplements vs. Medicare Advantage
Picking the Right Option
If you desire or require additional coverage beyond Original Medicare there are two popular options available: Medicare Supplement (Medigap) Policies and Medicare Advantage Plans. Medicare Supplement insurance plans and Medicare Advantage plans are both offered by private insurance companies. Both require you to enroll in Part A and Part B, as well as pay your monthly Part B Medicare premium. Should you try and fill the gap or take advantage of a convenient all in one plan?
For an easy comparison of Medigap to Medicare Advantage, review the following table:
Why pick a Medigap Plan:
- Freedom of Choice – you can choose your health care provider, physician, specialist, and hospital (if they are Medicare-approved and accepting new patients).
- Travel Benefits – MA plans are often bound to a specific location, Medigap cover access across the U.S. as well as some international travel medical expenses.
- Frequent Care Cost Savings – While Medigap Premiums are generally higher than MA Plans, Medigap generally covers more expenses resulting in less out-of-pocket expenses.
- Stability – MA plans may leave annual contract with Medicare and vary greatly , while all Medigap policies have the same structure regardless of insurers (though premiums may vary).
Why pick a MA Plan:
- Convenience – One stop shopping as most MA Plans include prescription drug coverage. Medigap enrollment would require an additional Part D prescription drug plan, including an additional monthly premium.
- Affordability – Lower monthly premiums, sometimes as low as $0, than Medigap policies, and out-of-pocket limits for catastrophic protection for otherwise healthy individuals that don’t require frequent care.
- Window of Opportunity – If you miss your initial window to enroll in Medigap, you may not be able to enroll in any Medicare Supplement plan. It is easy to enroll in an MA Plan in The Open Enrollment Period (OEP), regardless of whether you missed your initial window or not.
- Vision, Dental and Hearing – MA plans generally cover routine Vision, Dental and Hearing services that Medigap policies don’t.
- Tailored Benefits – Plans can be tailored or customized for an individual’s specific needs.
- Additional Benefits – Most MA plans offer additional benefits not covered by Medigap or Original Medicare.
For additional help comparing Medigap plans and Medicare Advantage plans available in your service area, call us at the Medicare Comparison helpline (866-391-7763) to speak to a licensed agent who is specially trained to help you understand your Medicare options, or request assistance here: medicarecompareusa.com/speak-with-an-agent
I like both options, can I have a Medigap policy and a Medicare Advantage Plan?
- If you have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare. If you’re not planning to leave your Medicare Advantage Plan, and someone tries to sell you a Medigap policy, report it to your State Insurance Department.
- If you have a Medigap policy and join a Medicare Advantage Plan, you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums. If you want to cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you won’t be able to get it back.
- If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy and a Medicare Prescription Drug Plan if you return to Original Medicare within 12 months of joining the Medicare Advantage Plan.
- If you had a Medigap policy before you joined, you may be able to get the same policy back if the company still sells it. If it isn’t available, you can buy another Medigap policy.
- If you joined a Medicare Advantage Plan when you were first eligible for Medicare, you can choose from any Medigap policy within the first year of joining.