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Oct 3, 20234 min read

Are Medicare Supplement Plans and Medicare Advantage Plans Identical?

Updated: Oct 10

Deciding how to get your Medicare benefits can be confusing. While Medicare Supplement (Medigap) Plans and Medicare Advantage Plans both offer additional coverage beyond original Medicare, they work very differently. Understanding the key differences between Medigap and Medicare Advantage is crucial for choosing the right type of Medicare coverage for your needs.

Below we’ll explain what each type of plan is, how they work, and the pros and cons of Medigap vs Medicare Advantage to help you determine which strategy is better for you.

What are Medicare Supplement (Medigap) Plans?

Medicare Supplement insurance, also called Medigap, refers to private policies that help pay for Original Medicare out-of-pocket costs like copayments, coinsurance and deductibles.

There are 10 standardized Medigap Plans labeled Plan A through Plan N. Each offers a different combination of benefits that fill in Original Medicare coverage gaps.

Medigap Plans allow you to visit any doctor or facility nationwide that accepts Medicare. You pay a monthly premium for the supplement policy in addition to your Part B premium.

What are Medicare Advantage Plans?

Medicare Advantage Plans, sometimes called Medicare Part C, are offered by private insurance companies contracted with Medicare. They provide all Medicare Part A and Part B benefits within a plan's network of providers.

Many Medicare Advantage Plans also include Part D prescription drug coverage. There are different types like HMOs, PPOs, and PFFS plans.

You must enroll in Original Medicare to join a Medicare Advantage Plan. Some plans have $0 premiums beyond the Part B premium, while others charge an additional monthly premium.

Key Differences Between Medigap and Medicare Advantage

Medigap and Medicare Advantage differ significantly:

Medigap

Supplements your original Medicare coverage
Use any provider nationally that accepts or so long as you're eligible for Medicare
Pay a monthly premium plus Part B premium
Covers coinsurance, copays & deductibles
Offered by private insurance companies

Medicare Advantage

Provides all Medicare beneficiaries benefits within the plan's network
Must use in-network providers to get coverage
May include prescription drug coverage
Often has $0 premiums
Run by private insurance companies

So in summary, Medigap supplements while Medicare Advantage replaces original Medicare. This leads to big differences in healthcare use, flexibility and costs.

Which Option is Best - Medigap or Medicare Advantage?

There is no one right Medicare option for everyone. Key considerations for choosing Medigap or Medicare Advantage include:

Budget and income - Advantage plans may have lower premiums
needs - Medigap provides open access to specialists
Location - Availability of Medicare Advantage Plans varies by area
Prescriptions - Many Advantage Plans include drug coverage
Travel habits - Medigap allows healthcare anywhere in the U.S.

Take time to understand your preferences and situation. Comparing plans each year allows you to switch to the type of Medicare coverage right for you.

Conclusion

While both offer ways to expand your Medicare benefits, Medicare Supplement and Medicare Advantage work very differently. Weighing your healthcare priorities will provide clarity on which strategy best fits your needs. With knowledge of the key distinctions, you can make an informed Medicare enrollment decision and choose the right health insurance.

FAQs

Are Medigap or Medicare Supplement Plans the same as Medicare Advantage Plans?

No, they are different. Medigap or Medicare Supplement Plans are designed to work alongside Original Medicare, while Medicare Advantage Plans are an alternative way to receive your Medicare benefits.

What is the difference between Medicare Advantage and Medicare Supplement?

The main difference is that when you enroll in a Medicare Advantage Plans it replaces your Original Medicare coverage, while Medicare Supplement Plans work alongside your Original Medicare coverage.

What is a Medicare Supplement Plan?

A Medicare Supplement Plan, also known as Medigap, is a private insurance plan that helps cover some of the out-of-pocket costs not covered by Original Medicare, such as deductibles, copayments, and coinsurance.

What is Medicare Supplement insurance?

Medicare Supplement insurance is another term for Medigap. It is a type of private insurance that helps cover the gaps in Original Medicare coverage.

Can I have both Medicare Advantage and Medicare Supplement Plans?

No, you cannot have both Medicare Advantage and Medicare Supplement Plans at the same time. You must choose one or the other.

How do Medicare Advantage Plans compare to Medicare Supplement Plans?

Medicare Advantage Plans typically offer additional benefits beyond what Original Medicare covers, while Medicare Supplement Plans focus on covering the out-of-pocket costs associated with Original Medicare.

Can I switch from a Medicare Advantage Plan to a Medicare Supplement Plan?

Yes, you can switch from a Medicare Advantage Plan to a Medicare Supplement Plan during certain enrollment periods, such as the Annual Enrollment Period or a Special Enrollment Period.

What do Medicare Advantage Plans offer?

Medicare Advantage Plans offer all the benefits of Original Medicare Part A and B) and may also include additional benefits such as prescription drug coverage (Part D Plan), dental, vision, and hearing coverage.

What is the difference between a Medicare Plan and a Medicare Advantage Plan?

A Medicare Plan refers to Original Medicare (Part A and Part B), while a Medicare Advantage Plan is an alternative way to receive your Medicare benefits.

Does Medicare Advantage provide the same coverage as traditional Medicare?

Medicare Advantage Plans must provide the same coverage as traditional Medicare (Part A and Medicare Part B), but they may offer additional benefits and have different cost-sharing requirements.