What everyone needs to know: Medigap vs Medicare Advantage
One of the major decisions that Medicare beneficiaries face is whether to enroll in a Medicare Advantage plan or a Medigap policy. Both have their own pros and cons, so it’s important to understand the differences. We get asked often, Medigap vs Medicare Advantage, which is better?
If you like the idea of an “all-in-one” plan and don’t mind using a network of providers, then Medicare Advantage is a great option. However, if you have a want more freedom in choosing your doctors, then Medigap is usually the better choice.
Ultimately, it’s important to compare both options carefully before deciding. To help make heads or tails, be sure to speak with a licensed insurance agent at Senior HealthCare Solutions. Call today, 866-633-4427.
What is the difference between Medigap and Medicare Advantage
Medicare Advantage and Medicare Supplement (Medigap) plans are different types of Medicare coverage. You cannot have both at the same time. Medigap plans are supplemental insurance and helps to fill gaps by paying out-of-pocket costs associated with Original Medicare. Medicare Advantage plans replaces Original Medicare and generally provide additional benefits.
In this article, we are going to explain the differences between Medigap and Medicare Advantage. We will cover the following aspects of these plans:
- General Overview everyone needs to know: Medigap vs Medicare Advantage
- What is Medigap
- What is Medicare Advantage
- Med Supp (Medigap) vs Medicare Advantage: 3 Key Differences
- 8 questions I need to know before choosing a Medicare plan: Medicare Advantage vs Medigap
- Free Medicare Benefits Review: Who can help me choose a Medicare plan?
- Compare Medicare Supplement Plans in 2023
- Compare Medicare Advantage Plans in 2023
- Frequently Asked Questions (Medicare FAQ)
Medicare Advantage and Medicare Supplement (Medigap) plans are different types of Medicare coverage. You cannot have both at the same time. Medigap plans are supplemental insurance and helps to fill gaps by paying out-of-pocket costs associated with Original Medicare. Medicare Advantage plans replaces Original Medicare and generally provide additional benefits.
What is Medigap Supplemental Insurance?
Medigap Plans are also referred to as Medicare Supplement Plans. Medigap coverage acts as secondary insurance to Original Medicare Part A and Medicare Part B. In other words, you have two insurance cards when you go to the doctor or hospital (your red, white, and blue Medicare card along with your Medigap Plan ID card).
Medicare Supplemental Plans have no network and require no referrals to see a specialist. As of 2022, there are over 1 million providers participating in Medicare.
Standardized Medigap Plans
Supplemental Medicare Plans are standardized. What does that even mean? Well, it works to your advantage, that’s for sure.
Imagine this; you are driving down the street and notice you need gas. As luck has it, there are 10 gas stations to choose from and all on the right side of the road. All have the same gas, but different prices. Do you stop at the store with the cheapest gas? Of course!
Same goes for Medigap Plans. If Humana offers a Plan N, then the medical coverage is the same for any other Plan N (Mutual of Omaha, United Healthcare, Aetna, Cigna, etc.).
So, deciding on a Plan N would become a price war between the different companies. We will let you know the lowest priced company and talk to you about reasons why you should choose or not choose a specific company.
There are 12 standardized Medigap Policies to choose from. The most popular Medigap plans are Plan F, Plan G and Plan N.
What is the Best Medicare Plan?
Plan F is deemed the best Medicare plan, simply because it provides the most comprehensive coverage. Plan F pays 100% on all Medicare approved services, including the Part A and Part B deductibles along with Part A and Part B coinsurance.
However, there are no Medigap Plans that include additional benefits for prescriptions, routine dental care, vision, or hearing (you add this coverage separately by purchasing stand-along insurance to pair with your Supplement Plan).
The average cost of Supplement Plans to Medicare varies greatly depending on the plan you choose, age, gender, location, and several other factors.
For example, a Plan G for a female age 65 living in Florida will be more expensive than the same person buying the same Plan G in Illinois. Call us today for quotes or compare Medigap rates online now. (Literally, rates vary from $30 a month to over $200).
How can I Enroll in a Medigap Plan?
To see if you qualify for a Medicare Supplement plan, you can call 866-633-4427 or click here to schedule your appointment.
To enroll in a Medigap Insurance Policy, you need to speak with a licensed agent contracted with the company you’d like to enroll. Thankfully for you, we’ve got you covered! Call us today, 866-633-4427.
We make it easy and remove the burden from you having to deal directly with the insurance company. Our team is here from day 1 and here to service your policy for as long as you need us.
What is Medicare Advantage?
Medicare Advantage Plans are also known as Medicare Part C, Medicare Replacement Plans, MAPD, Medicare Complete and our personal favorite, the “all-in-one” plans.
One difference between Medicare Advantage and Medicare Supplement is that your Medicare Advantage coverage will act as your primary and secondary payer (whereas with a Medicare Supplement, Original Medicare is primary and the Medicare Supplemental Plan in secondary).
In this case, you only must present one insurance ID card, not two. In short, your MAPD plan will “Replace” Medicare while the Advantage plan handles your health care needs and medical services.
What are the different types of Medicare Advantage Plans?
The two most common Medicare Advantage types of plans are HMOs and PPOs.
HMO is short for Health Maintenance Organization and PPO stands for Preferred Provider Organization. HMO Medicare plans are known for having extra benefits, small networks and may require referrals. PPO Medicare plans have great benefits, larger networks and do not require referrals.
Medicare Advantage Benefits
Medicare Advantage plans are designed to cover, at minimum what Medicare covers and, in most cases, they provide additional coverage. These extra benefits include, but not limited to:
- Prescription Coverage
- Give back benefits (Part B reimbursement)
- Flex Card for Seniors
- Over the counter credits
- Gym membership (Free and discounted)
- Transportation
- Dental, Vision, Hearing and much more!
Medicare Advantage Plans are not standardized. Plan availability, pricing and coverage will vary by the zip code and county you live in.
Sometimes, we see more than 50 Medicare Advantage Plans in one county…how can you ever sort through them all? Easy. Call us today, 866-633-4427 and allow one of our licensed insurance agents to do the hard work for you.
We are licensed and certified with over 25 top-rated carriers and will be sure to check your prescriptions and physicians accept the plan.
Another difference between Medicare and Medicare Advantage is the network. All Medicare Advantage Plans have a network, and some plans may require a referral to see a specialist. Some would say this is a disadvantage of Medicare Advantage Plans.
Check Eligibility, Quotes and Enroll in a Medicare Advantage Plan
There are plenty of affordable Medicare Advantage plans. The national average premium for a Medicare Advantage plan in 2022 is $62.66. However, there are many plans that offer a zero monthly premium. Yes, $0, zilch.
These plans are available to anyone eligible for Medicare and income is not part of the qualifying criteria to get a plan with $0 monthly premium.
There are no medical underwriting questions to qualify for a Medicare Advantage Plan.
To enroll in a Medicare Advantage Plan, you must be in a valid enrollment period. The most common is the Annual Enrollment Period (AEP), which runs each year from October 15-December 7th.
Outside of the AEP, you still may be able to change or enroll in a plan by using the Medicare Advantage Open Enrollment Period (MAOEP) or if you have qualified for a Special Enrollment Period (such as moving out of your current plans service area, loss of creditable coverage, change in income and many more).
Knowing all of the valid enrollment periods is next to impossible for most beneficiaries. Instead, read our related article here about Medicare Enrollment Periods. Or just call us today at 866-633-4427 and one of our friendly licensed agents will ask a few questions to determine eligibility.
What is the difference between a Medicare Supplement and Medicare Advantage Plan?
3 Key Differences
- Cost
- Network
- Additional Benefits
Download the full MedSupp vs Medicare Advantage guide here
8 questions I need to know before choosing a Medicare plan: Medicare Advantage vs Medigap
- Can I choose my own doctor and hospital?
- Is there a network?
- Am I required to get a referral?
- Do I pay a monthly premium?
- What are my out-of-pocket costs?
- Is drug coverage included?
- Is dental, vision or hearing included?
- When can I enroll?
Download our Medigap vs Medicare Advantage guide here
Free Medicare Benefits Review: Who can help me choose a Medicare plan?
We have a dedicated team of licensed insurance agents that are contracted and certified to offer you over 25 top-rated insurance companies. When speaking with one of our team members, be prepared to answer questions that will help the agent determine your eligibility and the most suitable plan for you.
From there, we will provide a free Medicare benefits review and help you choose a Medicare health plan. Call today at 866-633-4427.
Compare 2023 Medicare Supplement Plans
We’ve made our quoting tool available to you. Click the link, Compare 2023 Medicare Supplement plans in my area. The site will re-directed and asked for your age, zip code and tobacco use.
Then, you can select the plan(s) you are interested in seeing Medigap rates for. If you’d like to enroll in a Medigap plan, call 866-633-4427.
Compare 2023 Medicare Advantage Plans
No click-bait here. You have VIP access to our Medicare Advantage and Medicare Drug plan quoting tool. Click the link, Medicare Advantage Plans in my area. The site will re-directed and asked for your zip code.
The comparison tool, you can also plug in your prescriptions and physicians to ensure they are covered, as you compare plans.
You aren’t alone. If you start comparing plans and find you have questions or need assistance, call us at 866-633-4427.
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Frequently Asked Questions: Medicare Supplement vs Medicare Advantage
Should I switch from Plan F to Plan G?
You should consider changing from Medigap Plan F to Medigap Plan G. The coverage is nearly identical, and the premiums are lower with Plan G than Plan F. Read more here: Plan F vs Plan G vs Plan N
Does Medigap cover drugs?
Medigap Plans do not provide coverage for prescription drugs. If you have a Medigap plan or are considering one, you can enroll in a stand-along Medicare drug plan, to help lower cost at the pharmacy.
Can I switch from Medigap to Medicare Advantage?
During the Annual Enrollment Period, you can change your Medigap plan to a Medicare Advantage plan. The Annual Enrollment Period is each year from October 15th-December 7th.
If you are wanting to replace your Medigap plan with a Medicare Advantage plan outside of this window, you will need a Special Enrollment Period. To determine your eligibility for a SEP, call us today at 866-633-4427.
Are Medicare Supplement Plans Worth It?
Of course! Well, we think so anyway. But, we also think Medicare Advantage plans are worth it. We say it all the time, there is no plan that fits everyone’s needs and wants.
But, if you can afford a Medicare Supplement, they are worth their weight in gold.
Advantages of Medicare
Original Medicare has no network and helps to pay for some of your medical expenses at the doctor and hospital. However, Medicare doesn’t pay 100%. You should consider a Medicare Supplement or Medicare Advantage plan to help fully protect you from higher out-of-pocket costs.
Can you switch from Medicare Advantage to Medigap
Yes, you can switch from a Medicare Advantage plan to a Medigap plan. In most cases, you will need to answer medial questions to determine your eligibility in to the new Medigap plan you choose.
You can not change plans anytime throughout the year. The best thing to do (and easiest) is call 866-633-4427 or schedule an appointment with a licensed insurance agent today.
