How to Choose Between Medigap and Medicare Advantage

Whether you've just qualified for Medicare or are reconsidering your coverage, you might be wondering what the difference is between Medicare Advantage and Medicare supplement plans, aka Medigap, and how these forms of supplementary coverage work.

Any person can only have either a Medicare Advantage plan or a Medigap plan, so this choice can be extremely important when it comes to determining your medical care. We'll break down the key factors to help you decide which one is right for you.

What Are Medigap and Medicare Advantage?

Medigap is a supplementary coverage plan you can buy that covers the "gaps" in Original Medicare coverage. There are different levels of Medigap coverage, but they're designed to cover a higher percentage of the costs of what Original Medicare already covers.

Medicare Advantage is a private insurance alternative to Original Medicare. It offers all of the same coverage as Original Medicare, but can also add benefits such as dental, hearing and vision care, fitness and transportation perks, and out-of-pocket maximums. Medicare Advantage plans work like private insurance when it comes to having a selected network of providers that are covered, although PPO plans may cover a percentage of out-of-network expenses.

What factors should you consider when deciding between Medigap and Medicare Advantage?

Timing: If you've just qualified for Medicare due to turning 65, that tends to be the perfect time to select a Medigap plan. People who qualify for Medicare under the age of 65 may not qualify for Medigap depending on the state, and after your original open enrollment period at 65, you have to apply for Medigap and your approval and premium can be subject to medical underwriting. This can make premiums far more expensive or even bar you from certain Medigap plans.

Dental, vision and hearing care: If dental, vision, and/or hearing problems have been a major concern so far in your life, it's likely that these expenses will only continue throughout your life. Only Medicare Advantage plans can offer these supplementary benefits.

Premiums vs. expenses: Deciding on a Medicare plan often boils down to how much Medicare costs. It can be challenging to predict the full cost of healthcare as health expenses are naturally unpredictable, so the initial premium may jump out at first. Medigap plans tend to have a substantial monthly premium that's added on to the regular Plan B premium, while many Medicare Advantage plans have no additional premium at all. However, Medigap plans have lower deductibles than many Medicare Advantage plans as well as overall fewer out-of-pocket expenses.

Network coverage: In terms of insurance coverage, Medigap works the same way as Original Medicare. It offers a wide range of coverage throughout the country, so if you plan to split your time or travel frequently, it may be a good option. Some Medigap plans also offer international coverage, although not all. Medicare Advantage plans have insurance networks that work like other kinds of private insurance, so finding a plan that includes doctors and hospitals that work for you is key.

Source: iQuanti, Inc.


Categories: Healthcare Insurance

Tags: Medicare, Medicare Advantage, Medicare Supplement Plans, Medigap