Going on Medicare Part 3 – Medigap vs. Medicare Advantage

**This is Part 4 in a 5-part series intended to assist people turning 65 or going on Medicare with understanding Medicare, Medigap and other Medicare plan options.**

This article focuses on the difference in the two types of Medicare insurance plans – Medigap plans and Medicare Advantage plans. Contrary to what many people think, these are NOT the same thing, work very differently, and there are some distinct advantages/disadvantages to the different types of plans.Medigap vs. Medicare Advantage – Two Distinct and Very Different Options

Commonly, individuals going on Medicare refer to all plans that are secondary to Medicare as Medicare Supplements. This is, obviously, incorrect. An employer group health plan, Medicare Advantage plan, etc. is NOT a Medicare Supplement.

Medicare Supplements are also called Medigap plans. These two terms are interchangeable. These Medigap plans cover the same things from company to company – plans are Federally-standardized. Below, we’ve listed some major bullet-point differences between the plans:

  • Medicare Advantage plans have networks and some (HMOs) require referrals; Medigap plans do not have networks – you can go anywhere that takes Medicare.
  • Medicare Advantage plans have co-pays and deductibles but lower premiums; with Medigap, you pay a larger premium but it is more comprehensive coverage. The Medigap fills in the ‘gaps’ in Medicare A & B so you don’t, in most cases, have any out of pocket co-pays or deductibles.
  • Medigap plans do not include drug coverage or drug testing; Medicare Advantage plans sometimes include Medicare Part D prescription drug coverage, within their plan.
  • If you take a Medicare Advantage when first eligible (when leaving employer coverage or turning 65), you have to qualify medically if you ever want to return to the more comprehensive coverage of a Medigap plan. However, you can always go the “other way” – from Medigap to Medicare Advantage.

There are obviously some other factors to consider when comparing these two types of plans, but these are the primary differences in the plans. Other things you will want to consider are your own personal health, your financial means and the future of the Medicare Advantage program since the onset of health insurance reform.

What’s right for one person may not be right for another. It’s most advantageous to you to work with an independent agent who can simply provide all of the information for both types of plans, so that you can compare in one centralized place and make an educated decision.

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If you prefer to speak with someone by phone, please call me directly using the information below:J. Garrett Ball, President
Secure Medicare Solutions, Inc.Toll-Free: 877.506.3378

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