Medicare Supplement vs. Medicare Advantage

Understanding the Difference: Medigap vs. Medicare Advantage

Medicare Supplement (Medigap) Plans

• Medigap plans work alongside Original Medicare (Part A & B).

• They do not have networks, meaning you can see any doctor or hospital nationwide that accepts Medicare.

• Medigap helps cover costs like copayments, coinsurance, and deductibles that Original Medicare doesn’t fully pay for.

• You generally pay a monthly premium but have fewer out-of-pocket costs when you receive care.

• Medigap does not include prescription drug coverage, so you may need a separate Part D plan.

Medigap Plans A-N Explained

Medigap plans are standardized and labeled A through N, each offering different levels of coverage. Here’s a breakdown:

• Plan A – The most basic, covering Medicare Part A coinsurance and hospital costs, but not Part B deductible or excess charges.

• Plan B – Covers everything in Plan A plus the Medicare Part A deductible.

• Plan C – Covers most costs, including Part A and B deductibles, but is no longer available to new enrollees after 2020.

• Plan D – Similar to Plan C but does not cover the Medicare Part B deductible.

• Plan F – The most comprehensive, covering all deductibles, coinsurance, and excess charges. Only available to those eligible before 2020.

• Plan G – Covers everything Plan F does except the Part B deductible, making it a popular choice.

• Plan K – Covers 50% of many costs and has an out-of-pocket limit.

• Plan L – Covers 75% of many costs and has an out-of-pocket limit.

• Plan M – Covers part of the Medicare Part A deductible but not Part B deductible or excess charges.

• Plan N – Covers most costs but requires small copays for office visits and emergency room visits.

Medicare Advantage (Part C) Plans

• Medicare Advantage is an alternative to Original Medicare and often includes additional benefits.

• These plans have provider networks (HMO or PPO), meaning you may need to see in-network doctors to get coverage.

• Many Medicare Advantage plans include prescription drug coverage (Part D).

• You may have lower monthly premiums but can face higher out-of-pocket costs for services.

• If you travel often, you may have limited coverage outside of your plan’s service area.

Which Providers Offer Medigap vs. Medicare Advantage?

Not all insurance companies offer Medigap. Consult a Medicare Licensed Agent

Key Takeaways

• If you want the freedom to see any doctor nationwide who accepts Medicare, choose a Medigap plan from companies like UnitedHealthcare, Cigna, Aetna, Humana, or Blue Cross Blue Shield.

• If you’re okay with provider networks and potential restrictions, a Medicare Advantage plan may be a good choice, and most companies on the list offer them.

• If you’re looking for a Medigap plan, avoid companies that only offer Medicare Advantage, such as Fidelis Care, EmblemHealth, ElderPlan, WellCare, VillageCare, VNS Health, and HealthFirst.

How to Choose the Right Plan for You

• Do you travel frequently? → Choose a Medigap plan for nationwide doctor access.

• Do you want lower monthly costs? → Consider Medicare Advantage, but check the network first.

• Do you want extra benefits like vision, dental, and hearing? → Medicare Advantage may offer these perks.

• Do you want predictable costs and fewer out-of-pocket expenses? → Medigap may be a better option.

Need Help Selecting a Plan?

At Tantun Holdings, we help you find the best Medicare plan based on your needs, preferred doctors, prescriptions, and coverage preferences. Contact us today to explore your options and ensure you get the coverage that fits your lifestyle.

Understanding the difference between Medigap and Medicare Advantage can help you make an informed decision. Always check with your insurance provider to ensure your doctors are covered under the plan you choose.  

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