When signing up for Medicare, two common options for supplemental coverage are Medicare Advantage Plans and Medigap policies like Plan G. Medicare Advantage Plans are offered by private insurers approved by Medicare and provide all Original Medicare Part A and Part B benefits, often including prescription drug coverage as well.

Medigap Plan G is a private insurance policy that helps pay for Medicare out-of-pocket costs like copayments and coinsurance. Key differences between Medicare Advantage and Medigap Plan G include provider networks, prescription drug coverage, travel limitations, and out-of-pocket costs. Evaluating these plan variations enables you to determine which type of Medicare coverage better matches your healthcare priorities and budget needs.

Medicare Supplement Insurance Overview

Medigap, also called Medicare Supplement Insurance, refers to plans sold by private insurance companies to help pay Medicare out-of-pocket costs. Policies cover expenses like copayments, coinsurance, and deductibles associated with Medicare Parts A and B. The different plans are identified by letters such as Plan G.

To purchase a Medigap policy, you must be enrolled in Original Medicare Part A and Part B. The plans will coordinate with Medicare to provide additional coverage and reduce your healthcare costs throughout the year. But Medigap itself does not include prescription drug benefits.

Medicare Coverage With Medigap vs. Medicare Advantage

With Original Medicare plus a Medigap Plan, you'll have Medicare paying your healthcare claims directly, while your Medigap policy covers additional costs. This allows you to go to any healthcare provider accepting Medicare nationwide.

When you enroll in a Medicare Advantage Plan, Medicare pays a private insurer to administer your benefits. Medicare Advantage Plans often have restricted provider networks and referrals needed to see specialists. But many type of Medicare Advantage Plans also include prescription drug coverage.

So when you buy a Medigap policy,  Medigap supplements your existing Medicare benefits, while Medicare Advantage provides an alternate set of Medicare benefits through private insurance companies.

Medicare Advantage and Medigap Plan Basics

Medicare Advantage Plans may offer the same coverage as Original Medicare, but often have lower out-of-pocket costs like copayments and networks. Many also provide additional benefits those enrolled in Medicare (original) doesn’t cover — like dental, vision and hearing.

Medicare Supplement Plan plans offer standardized benefits that work alongside Medicare. For example, Plan G covers Medicare deductibles, coinsurance, copayments, and excess charges. But you must pay a separate premium for the Medigap policy.

Medicare Part B and Your Choices

To enroll in a Medigap plan, you must enroll in Medicare Part B insurance plan, which covers medical services and outpatient care. Medicare Part A covers hospitalization. Part A and Part B make up Original Medicare.

With Part B, some choose to add a Medigap Plan to lower Medicare out-of-pocket costs. Others may select a Medicare Advantage Plan that bundles Part A health insurance, Part B, and often prescription drug coverage in one policy.

To determine which option to pair with your Part B benefits, look at premiums, provider choice, prescription needs, travel plans, and other factors.

Medicare Plan Options

When becoming eligible for Medicare at 65, you have three main options for coverage:

1.     Original Medicare (Parts A and B) plus a separate Part D Plan and possibly a Medigap Plan

2.     Original Medicare (Parts A and B) plus a Medicare Advantage Plan that includes prescription drugs

3.     Just Original Medicare (Parts A and B) with no supplemental coverage

Most enrollees choose either Original Medicare plus a Medigap policy or a Medicare Advantage Plan to get more comprehensive coverage.

Medigap Plan G Details

Medigap Plan G is one of the more popular Medigap policy options. Here are some key Plan G details:

·        Provides all Medicare Part A coinsurance and hospital costs after your deductible is met

·        Covers Medicare Part B coinsurance or copayment amounts

·        Plan G pays 100% of the Medicare Part B excess charges

·        Includes coverage for the Medicare Part A deductible

·        Does not include foreign travel emergency care, vision, dental, hearing aids, prescription drugs

So in general, Medigap Plan G provides extensive coverage for the out-of-pocket costs associated with Medicare Part A and Part B services.

Choosing Medicare Advantage vs. Medigap

Should you opt for Medicare Advantage or Medigap to supplement your Original Medicare coverage? Here are some tips for choosing:

·        Review Advantage Plan networks to ensure your providers are included

·        Confirm a Medigap policy is available in your state and price options

·        Understand differences in out-of-pocket costs between plans

·        Check that your medications are covered by Medicare Advantage drug formularies

·        Consider any travel plans when looking at nationwide Medigap coverage

Doing your homework will help you find the right supplemental Medicare option.

Differences Between Medicare Advantage and Medigap

There are some notable differences between Medicare Advantage Plans and Medigap policies:

Medicare Advantage

·        Offered by private insurers contracted with Medicare

·        Networks, copays, coinsurance, maximum out-of-pocket limits

·        Often extra benefits like dental, vision, hearing

Medigap

·        Sold by private insurance companies

·        Standardized benefits that work nationwide

·        Covers Medicare deductibles, coinsurance, copayments

·        Does not cover prescription medications

Understanding these differences allows an informed choice between the two Medicare options.

Medicare Part D Prescription Drug Coverage

One major coverage distinction between Medicare Advantage and Medigap is prescription drug benefits.

Most Medicare Advantage Plans include Medicare Part D prescription drug coverage within the plan premium. This covers medication costs under one policy for Medicare beneficiaries.

With Medigap, your policy will not help pay for prescriptions. To get drug coverage, you would need to enroll in a standalone Part D prescription drug plan in addition to your Medigap policy.

Choosing a Medicare Advantage Plan

If you decide on a Medicare Advantage Plan or Medicare part c, here are some tips for choosing:

·        Check that your doctors and hospitals are in-network

·        Make sure any medications you take are on the drug formulary

·        Look for a plan with low copays and premiums

·        Consider extra benefits like dental, vision, hearing

·        Ensure the plan operates in the area where you live and travel

Working with an insurance broker who specializes in Medicare can simplify the process of selecting the right type of plan for your needs.

Differences Between Medicare Advantage and Medigap

When trying to determine whether Medicare Advantage or Medigap is a better choice, understanding key differences is important:

Medicare Advantage

·        Offered by private insurance companies

·        Limited provider network

·        Copays and out-of-pocket maximums

·        Often includes prescription drug coverage

Medigap

·        Sold by private insurance companies

·        Use any provider accepting Medicare

·        Pays Medicare deductibles, coinsurance

·        Does not cover prescriptions

Reviewing the type of coverage differences allows you to select the better option for your specific healthcare and budget needs.

We’re Here to Help

You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Golden Years Design Benefits a Call at 1-844-254-8998. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.