What Is the Difference Between Medigap and Medicare Advantage?

What is the difference between Medigap and Medicare Advantage? Understand supplemental insurance options and how they can benefit you.

Medicare is a great program helping to ensure that millions of people have access to the healthcare they need. Unfortunately, it only covers about 80% of costs, doesn’t pay for prescriptions, and there is no cap on out-of-pocket costs. Many people require supplemental insurance.

Fortunately, you have options. You can choose a Medicare Advantage plan or supplement your Original Medicare plan with Medigap. There are some key differences between the two programs and you can’t have them at the same time, so choose wisely.

So, what is the difference between Medigap and Medicare Advantage? Let’s find out.

What Is Medicare Advantage?

Medicare Advantages plans through Medicare-approved private companies wrap your health coverage up in one nice little policy. Everything that is covered under traditional Medicare is covered under Medicare Advantage. Plus, many prescription costs are covered and there is a cap on out-of-pocket costs, providing much-needed assurance.

Most of these plans operate as either HMOs or PPOs, both of which limit policyholders to local in-network doctors and hospitals.

What Is Medigap Insurance?

Medigap plans are additional insurance that you can buy to supplement your Original Medicare. It is an additional insurance policy that covers the holes left by Medicare.

You cannot buy a Medigap plan if you choose Medicare Advantage. Don’t listen to anyone who tries to sell you a Medigap plan if you’ve already chosen Medicare Advantage as this is illegal.

Medigap generally tends to be the more expensive option, but it also offers more complete coverage. Medigap works with all Medicare providers across the US. You don’t have to get special permission from your doctor, you can just show up at any facility accepting Medicare and receive covered treatment.

Additionally, some Medigap plans, such as Plans F and G, cover foreign travel medical emergencies as well.

This is a huge advantage if you live in different locations during different times of the year or travel frequently. It’s important to always have coverage, particularly as you get older.

You can peruse Medigap plans in your area here.

Medigap vs Medicare Advantage

Each option has its nuances, so it is important to consider all of your options carefully. Medigap tends to be a better, more flexible option for most people. This is why more people choose to stick with Original Medicare and take out a Medigap policy.

However, this option may not always be available to you. For example, if you are under 65 and are on Medicare because you are disabled, you may not be eligible for Medigap plans. Additionally, if you want extras like dental or vision insurance, you would have to choose Medicare Advantage.

The premiums for Medigap are higher, which is what scares some people off. But keep in mind that out-of-pocket costs for Medicare Advantage can add up quickly when you need care.

So, What Is the Difference Between Medigap and Medicare Advantage?

Understanding the differences between these two coverages is crucial to choosing the best medical insurance coverage for you. If you’ve been asking yourself “what is the difference between Medigap and medicare advantage?” we hope this article helped you understand.

Check out more of our articles for more tidbits of information!