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What is the difference between Medicare Advantage and Medigap?
Should I buy a Medigap or a Medicare Advantage plan?
Can a person have both Medicare Advantage and Medigap?
How do I compare Medicare Advantage plans?
Feb 8, 2024 · Discover the key differences between Medigap (Medicare Supplement) and Medicare Advantage to determine which plan is right for you.
- Paul Wynn
- Contributor
Jun 7, 2022 · Learn the differences between Medigap and Medicare Advantage, two coverage options for people with Medicare. Medigap supplements original Medicare, while Medicare Advantage is a private insurance alternative with different benefits and costs.
- Overview
- Medicare Advantage vs. Medigap
- Medigap plan benefits
- Medicare Advantage benefits
- Choosing Medigap and enrollment
- Choosing Medicare Advantage and enrollment
- Switching between plan types
- Summary
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Medigap and Medicare Advantage offer different health insurance options. Which is best for a person will depend on their particular needs.
Medigap is supplemental insurance for people who have original Medicare. Medicare Advantage, also known as Medicare Part C, is an alternative to this plan.
Key factors that a person may wish to consider when comparing plans include:
•level of coverage
•flexibility in choosing healthcare providers
•costs
Medicare Advantage and Medigap plans offer different coverage options. Each plan has its own rules and benefits that a person should bear in mind when deciding which one best meets their needs.
Medicare-approved private insurance companies administer both Medicare Advantage and Medigap plans.
The main difference between the two is how they work alongside original Medicare.
Medigap plans work alongside original Medicare’s Part A and Part B to help with out-of-pocket expenses, such as deductibles, coinsurance, and copayments. Some other benefits, such as emergency international coverage, may also be available, depending on the plan provider.
Although original Medicare pays for many of a person’s eligible healthcare expenses, it may not cover the entire amount.
Medigap is an insurance plan that supplements Medicare parts A and B. It can help fill the gaps that copayments, deductibles, and coinsurances can create.
One of the benefits of having original Medicare with Medigap is that a person may go to any doctor who accepts Medicare, meaning that most doctors within the United States are available to them.
People who frequently travel within the country may find this option beneficial. Some Medigap plans may also pay for emergency healthcare costs outside of the U.S., which may be valuable to some individuals.
There are, however, health issues and treatments that Medigap does not pay for, including:
•long-term care
Medicare Advantage plans, also known as Medicare Part C, are an alternative to original Medicare. Private companies that Medicare approves can offer these plans.
Sometimes called bundles, the plans have to provide all of the benefits of Medicare parts A and B, and they often also include coverage for prescription drugs. In addition, some Medicare Advantage plans provide extras that original Medicare does not offer, including vision, dental, and hearing benefits.
One of the key benefits of Medicare Advantage plans is their costs. Premiums are generally lower, starting from $0, and the plans put a yearly cap on out-of-pocket costs. As a result, after a person’s medical expenses have exceeded the cap, they do not have to pay anything further for covered services.
However, it is worth considering that Medicare Advantage offers less flexibility in the choice of healthcare providers, so a person must usually choose from within their plan’s network. Visiting healthcare providers outside of the network could result in higher costs.
Having Medicare parts A and B is a requirement for enrolling in a Medigap plan. The best time to buy a Medigap plan is during the 6-month open enrollment period (OEP). This window automatically begins the month a person reaches the age of 65 years.
Once the OEP ends, the company offering the Medigap plan may decline coverage if a person has specific medical conditions.
If the company does not accept the person’s application until after the 6-month period, a higher monthly premium may apply.
Medigap plans may differ depending on location, so a person can use Medicare’s search tool to look at the Medigap plans available in a particular zip code.
The website provides a range of plans with different deductibles. Medigap plans are standardized, which means that they all provide the same basic benefits. However, some plans may offer additional benefits.
Once a person decides on a plan, Medicare will provide contact information for the company administering the plan. A person can then complete enrollment by contacting the company directly.
A person may be eligible for a Medicare Advantage plan if they are enrolled in original Medicare and are living in the service area of the plan they wish to join.
Medicare Advantage plans work in different ways, so it is advisable for people to compare all the available plans in their area. They can do this using Medicare’s find-a-plan tool.
After deciding on a specific plan, a person can enroll by doing one of the following:
•enrolling through the company’s website
•completing a paper enrollment form and then mailing it to the private insurer
•calling the plan provider to give them the enrollment information over the phone
There are three opportunities for a person to switch from Medicare Advantage to Medigap.
•During the initial enrollment period (IEP): This 7-month period begins the month before a person reaches 65 years of age.
•During the Medicare Advantage OEP: This OEP runs from January 1 to March 31 each year. Between these dates, a person can drop their Medicare Advantage plan, return to original Medicare, or enroll in a Medigap plan.
•Shortly after enrolling: When a person first becomes eligible for Medicare and enrolls in a Medicare Advantage plan, they have 3 months in which they can switch back to original Medicare and enroll with Medigap.
A comparison of Medigap and Medicare Advantage shows that both options have pros and cons. There is no best choice for everyone because people have different preferences and requirements.
Medigap provides greater flexibility when it comes to choosing healthcare providers, while Medicare Advantage often has lower premium costs. It is important for a person to examine all the differences carefully before making a decision.
Learn the key differences between Medicare Advantage and Medigap plans, such as coverage, costs, and provider network. Find out how to choose and switch between these plans depending on your needs and eligibility.
May 20, 2024 · Explore the key differences between Medicare Supplement (Medigap) and Medicare Advantage plans, along with the pros and cons of both options.
- Amanda Krupa
- What is the main difference between Medicare Advantage and Medigap?One of the primary differences between Medicare Advantage and Medigap plans is that individuals with Medigap policies must be enrolled in Original...
- Is a Medicare Supplement plan better than an Advantage plan?Medigap and Medicare Advantage plans offer different benefits, and which will better serve you depends on your specific health needs. Medigap plans...
- What is the downside to Medigap plans?Medigap plans can be purchased in addition to Original Medicare and offer additional benefits that are otherwise not covered. There are 10 standard...
- What is the biggest disadvantage of Medicare Advantage?Some Medicare Advantage plans may come with a monthly premium, and the selection of in-network doctors and specialists may be limited. Costs may be...
- What is the difference between Plan G and an Advantage plan?Medicare Advantage plans have a yearly limit on out-of-pocket costs for services covered by Original Medicare. Medigap Plan G doesn’t include out-o...
- Can you have a Medicare Advantage plan and a Medicare Supplement plan?Individuals with Medicare Advantage can’t buy a Medigap policy, as Medigap policies can only be purchased when a beneficiary is enrolled in Origina...
Apr 5, 2024 · For many people, the decision between Medicare Advantage versus Medigap with original Medicare comes down to plan benefits and out-of-pocket costs. Medigap is Medicare supplement insurance that covers certain out-of-pocket costs for people enrolled in original Medicare (Part A and Part B).
Learn how Medigap and Medicare Advantage differ in network, flexibility, costs and benefits. Compare the pros and cons of each option and find out when to buy them.
A Medigap policy is different from a Medicare Advantage Plan (Part C). A Medicare Advantage Plan is another way to get your Medicare coverage besides Original Medicare. A Medigap policy is a supplement to Original Medicare coverage.
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Shop Advantage, Supplement (Medigap), & Part D plans from Aetna® Medicare Solutions. Explore Medicare Options Online Or Call & Speak To A Licensed Agent.
New to Medicare? Find a plan with dental, vision, and hearing benefits. Medicare Advantage plans from Medical Mutual – Your Hometown Medicare Insurer.
See Your Medicare Options. Top Advantage, Part D & MediGap Plans. Get Covered Today! Top Medicare Plans. Check Premiums for 2024. See Your Medicare Enrollment Options.
