The Difference between Medicare Supplement (Medigap) and Medicare Advantage (Part C)

I’m asked this question often in my efforts to help people with their Medicare coverage.

People will tell me “I have a Medicare supplement plan to help me above and beyond Original Medicare.”  

Then when I visit with them more, we find out they have a Medicare Advantage plan. “Which isn’t a bad thing, but they are different in how they work.”

They are both great plans, but they do work in different ways. Let’s go over the differences.

First thing First

You can only get a Medicare Supplement (Medigap) or a Medicare Advantage Plan (Part C) if you already have Original Medicare. See Blog Post https://bluecloverins.com/what-is-original-medicare/ to learn more about Original Medicare.

Medicare Supplements (Medigap)

Medicare Supplement and Medigap are the same plan with two names. A Medicare supplement plan is a plan that you would purchase by itself.

A Medicare Supplement (Medigap) can help pay for:

out-of-pocket cost under:

  • Medicare Part A (Hospital Insurance)
  • Medicare Part B (Medical Insurance)

They have plan options that you can choose from at any given time you are buying a Medicare supplement plan (Medigap). The plans include A, B, C, D, F, G, K, L, M, and N.

All insurance companies selling Medigap plans are regulated by state and federal laws. The plans of the same letter with two different insurance companies cover at the same level. However, different companies can charge different prices for the same letter plan.  It’s always beneficial to quote different companies to compare price.

These plans do not provide coverage for any of the following:

  • Medicare Part C (Medicare Advantage)
  • Medicare Part D (Prescription Drug Plans)
  • Any other type of private health insurance (Medicaid, Veteran’s Administration benefits, or TRICARE.

*Plan F – To purchase a plan F you would have had to turn 65 before the year 2020.

Medicare Supplement (Medigap) plans follow Medicare. Therefore, if a hospital or doctor accept Medicare, they will also accept your Medicare Supplement (Medigap) regardless of the plan or company.

Medicare Advantage Part C

A Medicare Advantage plan like a Medicare Supplement plan works along with Medicare part A and Medicare part B.

A Medicare Advantage plan can give services above what Original Medicare can offer such as:

  • Lower copays and deductibles
  • Routine dental care including cleanings, x-rays, and dentures
  • Routine vision care including hearing aids
  • Fitness benefits including exercise classes
  • Much more

*Not all plans offer these benefits. It’s important to review your plan in detail. You may ask someone who would know more like a licensed sales agent representing that carrier.

Many plans also include Medicare Part D prescription drug coverage. (Not all plans offer Part D prescription drug coverage)

Depending on residency there may be many Medicare Advantage plans to choose from. Some examples are HMO, POS, PPO and more.

Medicare Advantage plans do have a network of hospitals and doctors that accept the plan.

Medicare Advantage plans are based on your residency. There are some areas that will have many plan options, and some areas may not have a Medicare Advantage plan available.

Wrapping it Up

Medicare Supplement (Medigap) and Medicare Advantage plans are both great options and can fit anyone’s health care needs. They are different in how they work, and it is important to go over them both. It all comes down to preference and what is available to you. Seek some help and understanding from a licensed sales agent to help you learn more.

*This is a very generic overview of Medicare Supplement (Medigap) and Medicare Advantage plans. Click the links below to learn more or seek out a licenses sales agent to learn more about the plans and options in your area.

Medicare Supplement (Medigap)

https://www.ehealthmedicare.com/medicare-supplement-articles/medicare-supplement-insurance-plans/

Medicare Advantage (Part C)

https://www.ehealthmedicare.com/medicare-advantage-articles/what-does-medicare-part-c-cover/