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Medicare Advantage vs. Medicare Supplement Plans

Medicare Advantage (Part C) and Medicare Supplement (Medigap) plans are both types of private insurance plans that can work alongside Original Medicare, but they have different structures and offer different types of coverage. Let’s dive into each plan and then compare the advantages and disadvantages of each. 

What are Medicare Advantage Plans?

Medicare Advantage plans are an alternative to original Medicare and typically include coverage for hospital and medical services. They are private health insurance plans that must be approved by Medicare. 

These plans often include additional benefits beyond Original Medicare, such as prescription drug coverage, vision, and dental coverage. Medicare Advantage plans may have networks of healthcare providers, and people usually need to use doctors and hospitals within the plan’s network to receive the full benefits.

To join a Medicare Advantage Plan, you must:

  • Be a United States citizen or lawfully residing in the country
  • Live within your plan service area
  • Already be enrolled in Original Medicare (Parts A and B)
  • Disabled people under 65 with original Medicare are also eligible 

What are Medicare Supplement Plans?

A Medicare Supplement plan, also known as Medigap, is designed to help pay your share of medical costs left by Original Medicare. They help pay for certain out-of-pocket costs, such as copayments, coinsurance, and deductibles. Like Medicare Advantage, they are also offered by private insurance companies. Medicare Supplement plans do not provide additional benefits to vision, dental, or prescription drug coverage. They are meant to work alongside Original Medicare, not replace it. Medigap plans generally do not have networks, and beneficiaries can see any healthcare provider that accepts Medicare. 

You can be eligible for Medicare Supplement plans if you:

  • Are at least 65 years old
  • Are already enrolled in Original Medicare
  • You reside in a plans service area

Medicare Advantage vs. Medicare Supplement Plans: Pros and Cons

Medicare Advantage

Pros:

  • Additional benefits such as vision, dental, and prescription drug coverage and wellness programs.
  • Potential cost savings through lower premiums ($0 deductibles) and out-of-pocket expenses.
  • A network of healthcare providers, and care coordination services.

Cons:

  • Restricted choice of providers, hospitals, and suppliers based on the network 
  • You may need referrals and may be required to use specialists in your network, which may not be covered by Medicare Advantage

Medicare Supplement Plans

Pros:

  • There are no network restrictions, and your coverage is valid across the country, as long as they accept Medicare patients
  • Covers out-of-pocket costs not that aren’t covered by Original Medicare
  • No referrals needed
  • More predictable monthly costs

Cons:

  • Does not cover prescription drugs
  • Only covers one person, your significant other must buy separate coverage
  • Higher monthly costs than Medicare Advantage

Find The Right Plan For You With Benistar
Choosing between Medicare Advantage and Medicare Supplement plans depends on your individual preferences, health needs, and budget. Since you cannot apply for both, it’s important to compare the features of each plan before making a decision. Contact Benistar today at (860) 408-7000 to find out which plan could be best for you.

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