Medigap vs Medicare Advantage: What’s the difference?

If you are 65 years old, you will find that there are many options for your Medicare coverage. If you sign up for Original Medicare i.e. (Medicare, Parts A and B) within the open enrollment period, you can also sign up for a Medicare Supplementary Plan to complete your cover. Conversely, you can enroll in Medicare Part C instead of enrolling in a 2019 Medicare supplement plan. Medicare Part C is also known as Medicare Advantage.

When you sign up for Medicare Advantage, you cannot get a Medicare supplement plan. To make sure you get the best coverage for your situation, you need to know the difference between a Medicare supplement plan and a Medicare Advantage plan.

Medicare Advantage plans

The federal government demands that Medicare Advantage plans offer the same coverage as Original Medicare. The implication is that Medicare Advantage plan will offer coverage for inpatient and outpatient medical services. A Medicare Advantage plan offers benefits for Part A and Part B under a private health plan.

With a Medicare Advantage plan, you will continue to pay your Part B premium. These plans include deductibles and co-payments, but have an annual limit. Once you reach this limit, your plan will cover 100% of your medical expenses. The premium for a Medicare Advantage plan is typically between $ 0 and above $ 100 per month. Prescription drug coverage is included in most Medicare Advantage plans.

While prescription drug coverage and low premiums are attractive, we recommend a second option, i.e. a Medicare supplement plan.

Supplementary plans for Medicare

You will receive your primary coverage under Original Medicare if you choose a Medicare supplement plan (Medigap). Medigap plans are designed to fill the gaps which exist in Original Medicare. There are ten different Medigap plans. Each plan offers a variety of coverage, but some plans offer more coverage than others.

These plans cover most, if not all, of your Medicare-related costs. You can sign up for a Medigap Plan in the first six months after signing in to Part B. Part D does not include prescription drug coverage. In terms of the rest of the costs, Medigap plans have an average premium of about $ 150 to $ 200 per month. Age, health and location can affect your premium.

Which one is right for me?

Although both Medicare Advantage and Medigap plans have their benefits, we recommend a Medigap plan. The lower premiums on a Medicare Advantage plan may look attractive, but it will bring along some inconvenience. With a Medicare Advantage plan, you are not allowed to choose the doctor you want. If you select an HMO plan, only plan providers are displayed. If you choose a PPO, you will see all the providers. However, out-of-network providers will cost more. This means that you can see a significantly lower number of healthcare professionals and your preferred physician may be outside the network.

However, with a Medigap plan, you can visit any Medicare doctor. This allows a wide range of service providers at your fingertips. In addition, a Medigap plan will incur little to no out-of-pocket costs, while a Medicare Advantage plan would require deductibles and costs of up to $ 3,000 to $ 6,000 per year.