Choosing the right health care coverage is one of the most significant decisions you’ll make as you approach retirement. Medicare can provide a solid foundation of coverage, but it’s often not enough to cover all your health care needs and expenses.
While Medicare Advantage and Medicare supplement insurance (Medigap) are designed to help cover out-of-pocket health care expenses, they operate differently. Each can help round out your health care coverage.
What Are Medicare Advantage and Medicare Supplement Plans?
Medicare Advantage plans provide an alternative to Original Medicare and are offered by private insurance companies approved by Medicare. These plans combine Medicare Part A (hospital insurance) and Part B (medical insurance) and may include dental, vision and prescription drug coverage.
Medicare Supplement plans are policies designed to help pay some health care costs that Original Medicare doesn’t cover, such as copayments, coinsurance and deductibles. Medigap plans work with Original Medicare to provide health care coverage.
Key differences between Medicare Advantage plans and Medicare Supplement plans are as follows:
- Medicare Advantage
- Provides all-in-one coverage by combining Medicare Part A and Part B into one plan and includes benefits beyond Original Medicare
- Often has network restrictions, meaning you may have to see doctors within a specific network
- Usually has lower monthly premiums but higher out-of-pocket costs when you receive care
- May offer additional benefits like dental, vision and hearing coverage
You can typically enroll or change plans during the annual Medicare open enrollment period from Oct. 15 to Dec. 7 or during Medicare Advantage open enrollment from Jan. 1 to March 31.
- Medigap
- Must be enrolled in Medicare Part A and Part B to join
- Plans generally cover any doctor or hospital that accepts Medicare
- Typically has higher monthly premiums but lower out-of-pocket costs
- Does not include prescription drug coverage so a separate Medicare prescription drug plan is needed
- Focuses on covering costs left over from Original Medicare, offering no additional benefits
You must have Medicare Part A and Part B, and the best time to buy a Medigap policy is when you are first eligible to sign up for Medicare. If you wait until later, you may be subject to medical underwriting.
Contact Us
Whether you need Medicare Advantage or Medigap coverage depends on your health care needs, lifestyle and financial situation. Contact InsurePro to learn more about your Medigap and Medicare Advantage choices.
This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.