Confused about which way to go?
While Original Medicare (Part A and Part B) covers many healthcare expenses, it doesn’t cover everything. Even with covered healthcare services, you are still responsible for several copayments and deductibles, which can easily add up.
Medicare Supplement (Medigap) plans work with Original Medicare and help pay for costs that Original Medicare doesn’t cover. In contrast, Medicare Advantage plans are an alternative to Original Medicare. If you enroll in a Medicare Advantage plan, you are still in the Medicare program. However, you will get your Medicare benefits through the Medicare Advantage plan you choose.
The following charts help you compare the difference between Medicare Supplement Plans and Medicare Advantage Plans to help you make your decision.
What’s the difference between Medicare Supplement Plans and Medicare Advantage Plans?
Medicare Supplement Plans vs. Most Medicare Advantage Plans
| Concerns of Most Seniors: | Medicare Supplement | Medicare Advantage |
|---|---|---|
| Visit ANY doctor, specialist, hospital nationwide that accepts Medicare | YES | NO |
| Restrictive Networks of Doctors & Hospitals | NO | YES |
| Referrals Needed for Specialists | NO | YES |
| Expensive Out-of-Pocket Costs (Copays, Deductibles, Coinsurance) | NO | YES |
| High Maximum Out-of-Pocket Costs (approx. $6,700 – $10,000) | NO | YES |
| Health Plan Determines Approval for Tests, Services, & Procedures | NO | YES |
| Unwanted Plan Cancellation (Not By Your Choice) | NO | YES |
| Pre-Authorization Required for Some Tests, Services & Procedures | NO | YES |
| Potential Hidden Costs or Fees | NO | YES |
| Medicare Supplement (MEDIGAP) | Advantage Plan (HMO/PPO) |
|---|---|
| Original Medicare A&B is your Primary coverage. Medigap Plan is your Secondary coverage to pay your expenses. | REPLACE Original Medicare A&B with ALTERNATIVE coverage. Primary coverage comes from the insurance company’s plan. |
| FREEDOM & CHOICE to get superior quality healthcare! Visit ANY Medicare doctor, specialist, the hospital in the USA including elite providers who accept Medicare (NO restrictive networks) | Limited to providers in the plan’s network who must accept your specific plan (HMO/PPO). Typically, you cannot visit providers outside of your area’s network or you may pay additional costs. |
| NO referrals to see specialists Get immediate treatment which saves time and money! |
Usually required to get referrals for specialists and may be required to use limited network specialists. |
| Coverage goes with you across the United States. No network restrictions. Some plans cover foreign travel emergencies outside of the US. | Usually have network restrictions limited to your plan’s local area. Some plans allow you to go out of network, but you’ll pay much higher costs. Most do not cover you outside of the US. |
| You can get a Medigap plan anytime you want once you have Medicare Part B | Limited to certain times of the year when you can enroll or switch to another advantage plan |
| Affordable premiums to help limit various out of pocket costs Plan F covers 100% of ALL costs |
Usually, NO premium but you will pay copays, coinsurance, and deductibles. Most max-out-of-pocket costs can average $6,700- $10,000. |
| Part D Prescription Drug Plans provide broader coverage and reduce your out-of-pocket costs | Some plans include drug coverage, but your out-of-pocket costs tend to be much higher |
| SAVE MONEY! Eliminate or reduce out-of-pocket costs, copays, and deductibles Factor a fixed cost into your budget with NO surprises! |
You are responsible to pay the plan’s copays, deductible, and out-of-pocket costs. Becomes expensive when you need quality healthcare as bills will add up and you can get surprises anytime! |
