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Medigap vs. Medicare Advantage

What's the difference between Medigap and Medicare Advantage?

Medicare Advantage (Medicare Part C) and Medigap plans help supplement and, in some cases, expand upon your Medicare Parts A and B coverage. But the types of services they cover and your costs can vary, depending on which one you choose. Here are a few of their key differences. 

Costs

Usually, Medicare Advantage plans often have lower monthly premiums, but you’ll have to pay more out-of-pocket on things like copayments and deductibles. Medigap plans, on the other hand, come with higher monthly premiums but fewer out-of-pocket expenses.

Doctors and Hospitals

Before you choose a Medicare Advantage or Medigap plan, you’ll want to make a list of the doctors, specialists, and other health and wellness services you use regularly to be sure they are all covered by your choice. Some Medicare Advantage plans even include dental, vision, and hearing coverage while most Medigap plans do not. Medicare Advantage plans also have a limited selection of doctors and specialists within their network, and some will only provide coverage if you stay in-network - However, you’re always covered for emergency care.

Medigap is accepted by any doctor or hospital that accepts Original Medicare, so you have a huge list of providers to choose from.  

Locations

Another important thing to consider is where you live and how much travel you plan on doing. Medicare Advantage plans usually offer coverage in a certain geographical area. Some Medicare Advantage plans come with out-of-network coverage that works outside of your region, so be sure to check all the plan details.

Medigap provides coverage in all 50 states and many keep you covered when traveling outside the U.S. So, if you travel a lot or if you live in different states during certain times of the year, Medigap may be a better option. 

Prescriptions

Some, but not all, Medicare Advantage plans have built-in prescription drug coverage - so if there are particular medications and prescriptions you’ll need covered, check the formulary before signing up for a plan. With Medigap, you will need purchase your prescription drug coverage separately, like enrolling in a separate Medicare Part D plan. 

 

Pick the Best Coverage For Your Health Needs

You can’t have a Medicare Advantage Plan and a Medigap plan at the same time – so you’ll need to choose one or the other. Be sure to create a list of your doctors, prescription drugs, other health needs, and your budget, then compare the Medicare Advantage and Medigap plans available in your area to make sure that your needs are met. For more help choosing the right Medicare coverage, check out our Choosing a Medicare Plan page.

If you’re trying to choose between Medicare Advantage or Medigap, our licensed Medicare Advisors will be happy to help. 

 

Talk to a licensed Medicare advisor

To enroll in a Highmark plan or learn more call

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