Differences Between Medicare Advantage and Medicare Supplements

by Jeff Hale | Feb 16, 2021
Differences Between Medicare Advantage and Medicare Supplements

Medicare Advantage is also known as Medicare Part C. It is offered by private insurers that are contracted with Medicare. Part C plans cover the same benefits as Medicare Part A and B. It also covers extra services such as prescriptions, vision, dental, and hearing coverage.

Medicare Supplement plans, or Medigap, are sold by Medicare-approved private insurers. They help pay for the out-of-pocket costs Original Medicare does not cover, like deductibles or coinsurance.

Depending on what type of coverage you require with your Original Medicare coverage, you can choose either Medigap or Medicare Advantage.

What Do They Cover?

Medicare Advantage plans can be considered an alternative to Original Medicare as they provide the same coverage for inpatient and outpatient services. However, unlike Original Medicare, Medicare Advantage plans are sold by private insurers, allowing more coverage to be offered, such as dental, vision, hearing, gym memberships, and prescription drug coverage. These are services not covered by Original Medicare.

Medicare Supplement plans (Medigap) are a standardized set of health plans that are meant to cover some out-of-pocket costs leftover from Medicare Part A and Part B. Unlike Part C plans that can effectively replace Original Medicare coverage, Medicare Supplement plans are not meant to replace Part A and Part B. Rather, Medigap plans serve as supplemental insurance as they cover costs like deductibles, excess charges, coinsurance, copayments, and foreign travel emergency care.

Primary Differences

While you must be enrolled in Original Medicare to qualify for both Medigap and Medicare Advantage, there are other notable differences regarding eligibility.

When enrolled in a Medicare Advantage plan, you are still technically enrolled in the Medicare program. However, your coverage will not be provided by the federally administered Original Medicare, but through the Medicare Advantage plan, as it replaces Original Medicare.

Not only do you need to be enrolled in Original Medicare first before enrolling in an Advantage plan, but you must also live within your desired plan’s service area. By moving outside of this area, you will most likely lose coverage and will need to enroll in a new plan. Many Advantage plans also require their enrollees to receive care within specific provider networks. The only way you can receive care outside these networks and still have coverage is if it’s an emergency. Because Medicare Supplements work with Original Medicare and do not replace it, these plans are accepted by any medical provider who accepts Original Medicare.

However, when it comes to cost, Medicare Supplements usually have a monthly premium, while some Medicare Advantage plans can be as low as $0.

If you have any questions about which plan may fit your needs, contact us today at 541-301-7740. We can walk you through each plan to help you determine costs and coverage.