What's the Difference? Medicare Advantage vs. Medigap

Medicare Advantage vs Medigap

Medicare Advantage and Medigap are both options for individuals who are eligible for Medicare and looking to supplement their coverage.

Here are some key differences between the two:

• Coverage: Medicare Advantage plans are a type of Medicare plan offered by private insurance companies that provide all of the coverage of Original Medicare (Parts A and B), plus additional benefits such as prescription drug coverage, dental and vision services, and wellness programs and are referred to as Medicare Part C. Medigap plans, on the other hand, are supplemental insurance plans that help cover some of the out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance. These plans are standardized and are labeled as Plan(s) A through N although some plans have been discontinued.

• Costs: Medicare Advantage plans typically have lower monthly premiums than Medigap plans but have higher out-of-pocket costs for services such as deductibles, copayments, and coinsurance. Medigap plans, on the other hand, generally have higher monthly premiums but offer more comprehensive coverage with lower out-of-pocket costs.

• Network: Medicare Advantage plans usually have a network of providers that they contract with to provide services to their members. Networks may vary by plan and location and include Health Maintenance Organizations (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), Point of Service (POS) and Special Needs Plans SNP). Each type of network has specific requirements and cost sharing. Medigap plans do not have a network of providers and individuals can see any provider who accepts Medicare.

If you have questions about how to find the best Medicare coverage for you, we are here to help. Contact us for no cost, no obligation personalized advice.