As you approach the age of 65, you may be thinking about your healthcare options. Two popular options for Medicare beneficiaries are Medicare Advantage and Medigap plans. Both types of plans offer additional coverage beyond Original Medicare (Parts A and B) but have some key differences. In this blog, we’ll compare Medicare Advantage and Medigap plans to help you determine the best fit for you.
Medicare Advantage Plans
Medicare Advantage plans (or Medicare Part C) are offered by private insurance companies approved by Medicare. These plans provide all of the coverage offered by Original Medicare (Parts A and B). They often include extra benefits such as prescription drug coverage, vision, hearing, dental, and fitness programs. Medicare Advantage plans are mandated to provide at least the same level of coverage as Original Medicare but can offer additional benefits at an extra cost. Some Medicare Advantage plans may have lower monthly premiums than Medigap plans.
With a Medicare Advantage plan, you may need to use doctors and healthcare providers within the plan’s network to receive the lowest costs for services. Some plans require referrals from primary care doctors for specialist visits. Additionally, Medicare Advantage plans have an annual out-of-pocket maximum, the most you will pay in a given year for covered services. Once you reach this maximum, the plan will cover all additional costs for the year.
Medigap plans (or Medicare Supplement plans) fill the “gaps” in Original Medicare coverage, such as deductibles, copayments, and coinsurance. These plans are offered by private insurance companies and are standardized across the country. This means that the benefits offered by each plan are the same, regardless of the insurance company offering it.
Medigap plans do not offer additional benefits beyond what Original Medicare covers. However, suppose you prefer the flexibility to see any healthcare provider that accepts Medicare. In that case, a Medigap plan may be better for you. With a Medigap plan, you won’t need to worry about network restrictions or referrals for specialist visits.
Medigap plans generally have higher monthly premiums than Medicare Advantage plans, but they also offer more predictable out-of-pocket costs. With a Medigap plan, you’ll pay a monthly premium and, in most cases, will not have to pay any additional costs for covered services.
Which is Right for You?
When deciding between Medicare Advantage and Medigap plans, it’s important to consider your individual healthcare needs and preferences. A Medicare Advantage plan may be a good fit if you’re looking for additional benefits beyond what Original Medicare offers.
Suppose you prefer the flexibility to see any healthcare provider that accepts Medicare. In that case, a Medigap plan may be a better option. It’s also important to consider the costs associated with each plan, including monthly premiums, deductibles, copayments, and coinsurance.
Ultimately, the decision between Medicare Advantage and Medigap plans will depend on your individual circumstances. Speak with a licensed local insurance agent at Secure Insurance Group today to discuss your options and determine which plan best fits you.