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WebMD Connect to Care helps you find services to manage your health. When you purchase any of these services, WebMD may receive a fee. WebMD does not endorse any product, service or treatment referred to on this page. X Learn the difference between Medicare Advantage and Medigap to find the best plan for your health care needs. If Medicare won’t cover all your healthcare needs, Medicare Advantage and Medigap can help. Both Medicare Advantage and Medigap supplement original Medicare to provide more coverage, but there are some important differences between the two. What is Medicare Advantage?Medicare Advantage is private health insurance through Medicare that often also includes prescription drug coverage, or Medicare Part D. The plans usually provide coverage for things like vision, dental, disability services, home health, and other health care needs not covered by original Medicare. “Medicare Advantage plans offer the convenience of providing all of these services in one plan,” Erin Nance, MD, a New York City-based orthopedic surgeon, tells WebMD Connect to Care. “The costs and coverage details vary depending on the specific insurance company and what state you live in.” Medicare Advantage plans can be HMOs, PPOs, Special Needs Plans (SNPs), private fee-for-service (PFFS) plans, or Medical Savings Account (MSA) plans. While Medicare Advantage patients don’t need referrals to see a specialist, there are some limits when it comes to providers. “There are different types of Medicare Advantage Plans that may limit your ability to see a certain provider,” Nance says. “The vast majority of doctors accept Original Medicare and the Medigap supplemental insurance.” What is Medigap?Medigap, also known as Medicare Supplement Insurance, adds to original Medicare by filling in gaps where you aren’t covered. Medigap plans usually don’t cover vision, hearing, long-term care or at-home care. However, they're useful for specific types of coverage, such as health insurance while traveling or frequent emergency care. For instance, under Medigap plan N, foreign emergencies and hospital visits are covered, while emergency visits cost $50. Medigap plan F, a more expensive plan, pays for Part B deductibles while covering the 20% cost of services Medicare doesn’t pay. Medigap plans do not provide prescription drug coverage, and Medigap cannot be combined with Medicare Advantage. But Medigap plans are a way to tweak your Medicare to your specific situation while covering larger expenses. Which one is better?Both Medicare Advantage and Medigap provide advantages and disadvantages. Some advantages of Medicare Advantage include:
Some disadvantages of Medicare Advantage include:
Some advantages of Medigap plans include:
Some disadvantages of Medigap plans include:
How do you decide?“Make sure you have enough coverage to limit your financial liability in case of catastrophic injuries or disease,” Nance says. “While the plans that have better benefits often cost more, they will usually save you in the long run in terms of out-of-pocket fees.” Nance further recommends speaking to family and friends to compare experiences.
What is the biggest disadvantage of Medicare Advantage?The biggest disadvantage of Medicare Advantage plans is the closed provider networks, limiting your choice of which doctor or medical facility to use. Medicare Advantage costs are also largely based on how much medical care you need, making it more difficult to budget for health care costs.
Can I switch from a Medicare Supplement to an Advantage plan?You can make the switch from Medigap to Medicare Advantage. In many cases, Medicare Advantage can be a better choice and provide the best mix of coverage, so it could be a good idea to make the switch.
Can I have both Medicare Advantage and supplement?While you can't add a Medicare Supplement plan to a Medicare Advantage plan, the added benefits MA plans provide help make up the difference when it comes to out-of-pocket costs. One great feature is the security of an annual limit on out-of-pocket costs, after which you pay nothing for covered services.
What is another name for Medicare Advantage?Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits.
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