When it comes to Medicare plans, understanding your options is important. Two common types of Medicare plans are Medicare Supplement Insurance Plans, also known as Medigap, and Medicare Part C, also known as Medicare Advantage plans. The terms “Medigap” and “Medicare Advantage” may sound similar, but they work in different ways. Medigap acts as a supplement to Original Medicare, helping cover costs like copayments and deductibles, while Medicare Advantage plans serve as an alternative to Original Medicare and are sold by Medicare-approved private insurance companies. In this article, we’ll walk you through the key differences between Medigap plans and Medicare Advantage plans so you can make the choice that best fits your health needs and lifestyle.
Medigap Plans Are Supplemental Insurance for Original Medicare
Medigap, also known as Medicare Supplement Insurance, is a type of private insurance that helps cover some of the costs that Original Medicare (Parts A and B) doesn’t pay for—like copayments, coinsurance, and deductibles. It’s designed to “fill the gaps” in your Original Medicare coverage, which is where the name comes from. There are 10 types of Medigap plans, each categorized by letters: A, B, C, D, F, G, K, L, M, and N.
Medigap plans are offered by private insurance companies but are standardized by the government, meaning the benefits for each plan type are the same no matter which company offers it. To enroll in a Medigap plan, you must already have Original Medicare, and you’ll typically pay a monthly premium for your Medigap policy in addition to your Part B premium.
Medicare Advantage Plans Are An Alternative to Original Medicare
Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare offered by private insurance companies approved by Medicare. Medicare Advantage plans must legally offer the same coverage as Original Medicare but may include additional routine benefits. With a Medicare Advantage plan, you still have Medicare coverage, but your coverage is managed by a private insurer.
Key Differences Between Medigap and Medicare Advantage
Medigap | Medicare Advantage Plans | |
Purpose | Helps pay for costs not covered by Original Medicare, like coinsurance, copayments, and deductibles | Serves as an alternative to Original Medicare |
Provider Network | Any doctor or hospital that accepts Medicare plans | May be limited to a specific network of providers |
Plan Structure | Standardized plans across carriers | Varies by location and carrier |
Additional Benefits | None | May offer routine benefits not included in Original Medicare |
Choosing Between Medigap and Medicare Advantage Plans
When it comes to getting the most out of your Medicare coverage, choosing between a Medigap plan and a Medicare Advantage plan is a big decision. Each option offers different benefits, costs, and coverage structures, so it's important to understand how they compare before making a choice that fits your health needs and lifestyle.
Here are some key factors to consider when deciding between Medigap and Medicare Advantage:
Cost: Consider monthly premiums, deductibles, copays, and out-of-pocket limits.
Flexibility and Coverage: Look at whether your preferred doctors, hospitals, and pharmacies are covered.
Additional Benefits: Consider whether you could benefit from additional routine benefits not included in Original Medicare.
Health Needs: Think about your current and expected medical needs when comparing coverage levels
Helpful Resources
Explore the Medicare.gov resources below to learn more about Medigap plans and Medicare Advantage plans.
New to Original Medicare, on Medicare but recently moved, or lost your health insurance? Click “Get a Free Quote” below to see if you’re eligible for a free, no-obligation Medicare Advantage plan review with a licensed insurance agent.
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