Comparing Medigap VS Medicare Advantage

Two of the best ways to protect yourself from having to pay the rising costs of health care is to get a Medigap plan or enroll in a Medicare Advantage plan. 

One of the most frequently asked questions Medicare enrollees ask is, “should I go with a Medicare Advantage plan or a Medigap plan?” this is a good question, but the answer can be confusing. Each type of plan provides added coverage for your Medicare coverage, but there have several differences that can completely change your health care experience. Keep reading to find out what Medicare supplemental insurance companies offer and at what cost. If you simply have questions about what the purpose of Medicare is, we can help you find the answers you are looking for.

To do a good comparison of Medigap vs. Medicare Advantage plans it is important to get a good understanding of how each works with the Medicare program. We are going to break down each of these very useful health insurance programs, however if you need an immediate quote just complete the form on the left.

What is a Medigap Plan?

Medigap plans, also called Medicare supplements, were designed to fill the gaps left by traditional Medicare coverage (hence the name “Medi-Gap”). These insurance policies are sold by private insurance companies to give you extra health care coverage to work with Medicare. There is a total of nine coverage gaps left by Medicare Part A and Part B. The ten Medicare supplement plans will cover between four and all nine of these gaps. Each Medigap plan covers different holes and has different out-of-pocket expenses.

Each medigap plan is the same across the country, meaning that no matter which state you are in, the plan is going to cover the same things as the same plan sold in a different state. It should be noted that not every state sells all ten plans. Are you looking for SC Medicare Supplemental Plans? We can guide you in your search.

Medicare supplement Plan F is the most popular of all the plans because it covers all the nine gaps and makes it very easy to budget for your expenses (learn more about Medicare Supplement Plan F). If you’re looking for less expensive coverage with more holes, Plan C and Plan G are also popular options. So when making a comparison of Medicare Advantage vs. Medigap, you need to remember that Medigap policies work WITH Medicare to provide you with better coverage.

If you’re looking for a less expensive plan that leaves a few more holes in the coverage, Medigap plans like A and B will save you money every month, but will leave you with more expenses that you’ll have to pay out-of-pocket.

What is a Medicare Advantage Plan?

Medicare Advantage, frequently called Medicare Part C, was designed to give people going on a Medicare a choice between a traditional
Medicare plan and a private health insurance plan. So with MA plans, you can go out and get a private health insurance plan, and the money that would have gone to pay your Medicare coverage goes to your MA plan. This allows a person to get much lower rates for their premiums and depending on what coverage you pick the premiums could even be zero.

With Medicare Advantage plans, they can cover a variety of different expenses. They will typical have deductibles and co-pays that you’ll pay for doctor’s appointments and hospital visits, but most MA plans have Part D, which covers prescription drugs. The Advantage plans have annual out-of-pocket limits that will prevent you from breaking your bank on hospital costs every year.

To recap the information, when you look at Medicare Advantage vs. Medigap, Medicare Advantage plans REPLACE the coverage you get with traditional Medicare.

Comparing Medigap vs. Medicare Advantage Plans

So looking at the bottom line of Medigap VS Medicare Advantage plans, Medicare supplement policies are added to and work with traditional Medicare coverage, while MA plans replace the coverage you would get with a Medicare policy with a private health insurance plan. The both offer much-needed coverage for an affordable price.

Making the Decision

Which one is better? The truth is it depends on where you live. If you live in an area with robust MA plans, then you may be better off and spend less money with one of them. On the other hand, if the Medicare Advantage policies available in your area are weak or non-existent, then a Medigap policy may be the best option for your needs.

Now that you understand what a Medigap plan and an Advantage plan is, you can decide which one will work better for you. Each one has its pros and cons, so how do you choose? There are a couple of questions you can ask yourself to make your decision a little easier.

The first question is, do I plan on moving? One of the biggest differences between the two types of plans is the areas they are effective in. It’s very important to take note of the area that you live in and the coverage that you can purchase. With a Medigap policy, you aren’t really limited to which doctors or hospitals you can use. As long as they accept Medicare, you should be able to use their services. The vast majority of doctors and hospitals accept Medicare, which means that you’ll have very few problems finding health care.

On the other hand, Medicare Advantage plans aren’t as simple as finding a doctor that accepts Medicare payments. With an Advantage plan, you’re limited to the doctors and hospitals that are a part of the Advantage network. If you go to any doctor or hospital that is outside of the network, you could be looking at paying huge bills for health care. If you do a lot of traveling or plan on moving around a lot during retirement, an Advantage plan could bring some severe pains.

You also have to consider your health. Are you in excellent health with few problems? Sure, you can’t predict the future, but you can make some guesses on any procedures or treatments that you’ll need in the future. Do you have a family history of having problems later in life? Your health is going to play an important role in the type of policy that you choose. If you’re in excellent health, then you might be able to go with a Medigap plan that has less coverage that saves you money.

The other question you should ask yourself is, “How much do I want to pay out-of-pocket?” this might seem like an odd question, but it will have a significant impact on which type of plan you choose. With a Medigap plan (depending on which plan you choose) you’ll have very few out-of-pocket expenses, aside from your monthly premiums. On the other hand, Medicare Advantage plans have much higher out-of-pocket costs because of their deductibles and copays. If you have the money to cover the cost of out-of-pocket expenses, you can save money on monthly premiums by going with an Advantage plan.

The Bottom Line

Unfortunately, there is no “one plan fits all” option that we can suggest to everyone. Each person has different needs and preferences, which mean that each will have a plan that will work better for them. There is a lot to consider when you’re trying to get the Medicare coverage you want, but don’t let the confusion stop you. Because there are so many different insurance companies and various plans to consider, talking with companies could take you a week or more, but we know your time is valuable. Regardless of what type of policy you choose, it’s important that you have adequate health care coverage, and you aren’t left with massive medical bills that you can’t pay for.

The only way to answer the Medicare Advantage vs. Medigap the question is to get a set of Medicare supplement quotes for both types of coverage in your area. At our company we are proficient at getting people coverage from all the different types of senior health insurance. We are independent brokers, so we can help you get the best policy for your needs and answer the Medigap VS Medicare Advantage question. Because we don’t work for a particular company, we aren’t going to try and sell you expensive plans that you don’t need. We only will show you the best coverage for the best prices.