Medicare Medigap
Learn more about the different Medicare options and how to make the best decision for your health and wellness needs.
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).
Coverage Options
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:
- Enroll in a Medicare Advantage plan (Part C), which includes Part A, B, and usually Part D bundled together
- Or stick with your Original Medicare coverage, and consider optional add-ons like Medigap and Part D
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.
Now let's explore these options:
Medicare Advantage Plans
The all-in-one alternative with extras.
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.
Medicare Supplement Plans
Covers costs in Original Medicare Parts A and B.
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 vs. Medigap—Key Differences
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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Next Steps
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Enroll in Generations Advantage
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We're here to help guide you.
Local benefit specialists are here to help you with your questions or give you personalized assistance—call 877-751-0331 (TTY: 711) to speak to a representative.
If you're ready to enroll, get started here: