We’ve heard it before–Medicare terms can be so confusing! What’s the difference between Medicare, Medigap, “Med Supp”, Medicare Advantage, Medicaid?
We’re here to help you understand these terms, and talk through the differences between Medicare Advantage and Medicare Supplement (Medigap).
When we talk about Original Medicare, we are referring to Parts A and B. Most people who qualify for Medicare (upon turning 65, or having a qualifying disability and/or health condition) would be eligible to enroll in Original Medicare. Original Medicare covers most of your hospital and inpatient care, as well as 80% of doctor and outpatient services, but does not automatically include coverage for prescription drugs.
When you enroll in Medicare Parts A and B, you will need to make a choice:
While Medicare Advantage often brings more benefits beyond basic Medicare, Medigap focuses on minimizing what comes out of your pocket from those basics.
These plans offer predictability with deductibles, co-insurance, and co-payments, as well as freedom to choose any doctor that accepts Medicare. However, these plans have a separate premium from Part B, and typically do not include prescription drug coverage (Part D). If you’re someone who values the ability to see specialists across the country without referrals, and the predictability of steady payments, you may be a fit for a Medigap plan.
These plans combine the benefits of Part A, Part B, and usually Part D, into a single plan.
They often include added coverage for dental, vision, hearing, and more—giving you a more comprehensive health care package. Plus, with Medicare Advantage, it's easier to manage your health care with one plan, one card, and one point of contact.
If you valuable health benefits not included in Original Medicare and prefer the convenience of bundled coverage under a single plan, Medicare Advantage may be a good fit for you.
With this option, you get your coverage for Parts A and B through Original Medicare. Then you can add a Medigap (Medicare supplement) plan to cover some of the out-of-pocket member costs, like deductibles and coinsurance.
Medigap only covers items included in Original Medicare Parts A and B.
It does not include additional benefits like presciption drugs, dental, vision, etc.
Medicare Advantage (Part C) plans cover Part A, Part B, and usually include Part D Prescription Drugs. They are a true alternative to Original Medicare.
By comparison, Medigap supplements Original Medicare coverage and doesn't cover Part D (you'll need a separate plan).
Typically bundled in Medicare Advantage, not included under Medigap.
Some Medicare Advantage plans may have network restrictions; Medigap offers more flexibility to see any provider that accepts Medicare.
Medicare Advantage plans often have lower or $0 premiums, caps on out-of-pocket costs, but may include copays, whereas Medigap has higher premiums but fewer out-of-pocket costs.
Referrals are typically necessary within Medicare Advantage HMO-style plans; usually not needed with Medigap.
Medicare Advantage plans usually includes extras like dental, vision, hearing, and wellness benefits, rarely found in Medigap plans.
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We offer a variety of Medicare Advantage plans designed to fit your health care needs and budget.
Is your doctor in our network? We have over 15,000 providers who participate in the Generations Advantage network.
Use the Drug Formulary Search Tool to find detailed coverage and tier information for specific medications.
This guide can help answer your questions and give you valuable information about Medicare.
Have additional questions? Join us for a free Medicare Advantage plan seminar.
Ready to enroll? Our enrollment process only takes about 10 minutes—have your Medicare card ready and let's get started.
Whether you’re exploring plan options or already a Generations Advantage member, our team is ready to help.
Prospective Members: Call us at 1-877-547-7072 (TTY: 711)
Current Members: Call Member Services at 1-866-544-7504 (TTY: 711)