The choice of health insurance is an important decision. When choosing Medicare coverage, you have many options.
There are additional plans that join with your Original Medicare (Parts A and B), called Medicare Advantage and Medicare Supplements. They may give you the personalization to meet your unique needs. While both plans can offer coverage that other parts of Medicare neglect, you can’t buy both Medicare Advantage and Medigap. This information can be confusing, but we’re here to provide clarity.
How Do These Plans Differ?
Medicare Advantage, or Part C, is a private option covering your Part A, B, and often D plans, among other benefits. It essentially replaces Original Medicare.
Medicare Supplements, or Medigap, are a different group of plans that help cover out-of-pocket expenses like copays and coinsurance. You can buy Medigap on top of your other Original Medicare plan (parts A, B, or D).
A Comparison Table
Here’s a side-by-side comparison of both plans:
|Medicare Advantage (Part C)||Medicare Supplement (Medigap)|
|Eligibility||Age 65 or older, enrolled in Parts A & B||Age varies by state, enrolled in Parts A & B|
|Costs||Varies by the plan provider||Varies by age & the plan provider|
|Specific Coverage||Everything that Parts A, B, & sometimes D cover, and extra benefits for vision, hearing, and dental; varies by provider||Costs such as coinsurance and copayments; doesn’t cover vision, hearing, or dental|
|Spousal Coverage||You must have your own policy||You must have your own policy|
|Worldwide Coverage||You must be within your plan’s service area||Covers foreign travel emergency care within 60 days of your trip|
|When to Buy||During open enrollment or your initial enrollment into Parts A & B — 3 months before & after your 65th birthday||During open enrollment or your initial enrollment into Parts A & B — 3 months before & after your 65th birthday|
When Is Medicare Advantage a Good Fit?
Medicare Advantage plans may be suitable for you if:
- You already have Medicare Parts A, B, and D.
- You want extra benefits like dental, vision, and hearing.
- You’d rather regulate one plan for all your insurance needs.
- You have an approved provider that you’re happy with — and you know they accept Medicare Advantage plans.
When Is Medicare Advantage Not a Good Fit?
Medicare Advantage plans may not be suitable for you if:
- You wish to keep the same rates — the rates change each year.
- You’re worried about paying for additional coverage you won’t use.
- You often travel or expect to while on Medicare. You must live in the plan’s coverage area, except for emergencies.
- You wish to keep the same provider every year — the requirements for approved providers change each year.
When Is Medigap Coverage a Good Fit?
Medicare supplements may be suitable for you if:
- You need help with out-of-pocket costs.
- You already have vision, dental, or hearing coverage.
- You plan to travel abroad and like to be prepared.
- You’d rather choose the amount of coverage for out-of-pocket costs you’re buying.
When Is Medigap Coverage Not a Good Fit?
Medicare supplements may not be suitable for you if:
- You want coverage for extended hospice or long-term care.
- You don’t use a lot of healthcare and don’t typically hit your annual deductible.
- You have a Medicare Advantage plan already — a carrier cannot sell you Medigap in this case.
Compare Your Options with a Licensed Agent
Remember, you must pick either Medicare Advantage or Medigap. It’s critical to know your needs and select the plan that best suits them. But this can be a daunting task to solve on your own! When you’re ready, Trusted Senior Specialists can help you compare your options. Give us a call at (844) 325-8710 or contact our team online.