Understanding the Differences: Medicare Advantage vs. Medicare Supplement Plans


By Justin Scheiner 

When it comes to healthcare for seniors, navigating the maze of Medicare options can be a daunting task. At the heart of the confusion often lies the choice between Medicare Advantage and Medicare Supplement plans, also known as Medigap. Both options offer coverage beyond Original Medicare, but there are key differences to consider. In this blog post, we’ll break down those differences to help you make an informed decision. 

What is Medicare Advantage? Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare, covering everything that Parts A and B do along with additional benefits like vision, dental, and hearing. These plans often include prescription drug coverage as well, combining numerous healthcare needs into a single plan.

Pros: – All-inclusive coverage – Often includes extras like dental and vision – May include prescription drug coverage.

Cons: – Limited network of doctors and hospitals – May require referrals for specialists – Out-of-pocket costs can be unpredictable. More of a pay as you go insurance. 

What are Medicare Supplement Plans (Medigap)?  

Medigap plans are designed to supplement Original Medicare by filling the gaps in coverage. These plans don’t offer additional benefits like vision or dental; rather, they cover costs like copayments, coinsurance, and deductibles associated with Parts A and B. 

Pros: – Wide network of doctors and hospitals – Predictable out-of-pocket costs – No referrals required for specialists 

Cons: – Doesn’t cover additional services like dental and vision – Requires a separate prescription drug plan (Part D) – Monthly premiums can be higher

Key Differences:

Flexibility vs. Coverage – **Medicare Advantage** offers a one-stop-shop for healthcare services but within a restricted network. – **Medigap** gives you the freedom to choose doctors and specialists but only supplements the coverage provided by Original Medicare.

Costs – **Medicare Advantage** often has lower monthly premiums, but costs can vary depending on services used. – **Medigap** generally has higher monthly premiums but offers predictable costs for services.

The Bottom Line

The choice between Medicare Advantage and Medicare Supplement plans boils down to what you value more: the convenience of having all your healthcare services bundled together, or the freedom to choose from a wider network of providers. Both have their merits, and your decision will depend on your healthcare needs, budget, and lifestyle. Take the time to assess your healthcare priorities and financial situation to make the best choice for you. As always, MedigapRx is happy to help you find the right plan for all your needs. 

If you have any questions please feel free to reach out to us. We are licensed with all major carriers and throughout several states. We believe an educated consumer makes for the best client. 

Justin Scheiner