Medicare-Eligible Health Insurance Article

15 Jul

Medigap vs Medicare Advantage: Which is the Best ?

By Katie Banks+

 71 Recent Comments

The first thing that most Medicare-Eligible people considering health care ask us is, “Which is best: Medigap vs Medicare Advantage.”  Before we can answer the question, however, we want to discuss how each product works because they are drastically different.

What is Medigap and What is Medicare Advantage?

MEDIGAP
Medigap refers to a group of supplemental insurance plans that work in conjunction with your regular Medicare benefits. They cover many expenses not covered under Original Medicare such as additional hospital days or international travel.  Also Medigap plans often cover expensive deductibles or copayments that are charged to Medicare patients without Medigap. These cost can add up to hundreds of thousands of dollars should you have a major illness or accident.

The benefits of Medigap plans are standardized by the federal government, meaning that plans sold by different insurance companies all offer the same benefits. Click here to visit Senior65.com to get a quick Medigap quote

Medigap does not cover prescription benefits so most people purchase additional Rx coverage through Medicare Part D.

Now that you know a little more about Medigap, learn does Medigap cover dental?

MEDICARE ADVANTAGE
In contrast, Medicare Advantage (MA) plans replaces Original Medicare. Medicare Advantage plans are run by private companies and must provide equivalent coverage as Medicare A and B, but vary beyond this minimum set of benefits. Medicare Advantage can still leave open the gaps that Original Medicare leaves in case of major medical issue. Some Medicare Advantage plans offer dental, vision, or prescription coverage. Many Medicare Advantage plans are HMOs, therefore have a smaller network of doctors than those that accept Original Medicare.

Medicare Advantage plans are often less expensive than Medigap plans. So, if you’re willing to deal with the restricted network (i.e., you don’t plan on traveling the country) and your funds are limited, the Medicare Advantage plan may be the best choice for you. 

One nice thing about Medicare Advantage is that each year there is an Annual Enrollment Period (AEP) where you can switch companies. The AEP is from October 15 to December 7 each year. If you are looking to get a quote visit Senior65.com’s instant Medicare Advantage quote

Medigap Medicare Advantage
Typically More Expensive Typically Less Expensive
Fills in the cost “gaps” not covered Medicare Equivalent coverage as Medicare
Same Network of Doctors as Medicare Some times smaller network of doctors than Medicare
Does not cover RX Can include RX coverage
Contact us for a recommendation Contact us for a recommendation

       

Making the Choice of Medigap vs Medicare Advantage

At the end of the day, only you can determine which is the correct type of plan for you. We like to say that the decision comes down to “pay now or pay later.”

Pay Now Medigap plans are usually more expensive each month but will save you a significant amount money if you need extensive medical services.  If you budget can afford a Medigap plan, they may be a good way at protect your wealth.

Pay Later Medicare Advantage will almost always be less expensive in the short run because their monthly premiums are usually lower than Medigap.  Out-of-pocket costs for many services such as hospital stays, however, can be more expensive with Advantage plans than they are with Medigap plans. You should contact your physicians to ensure you can keep seeing them if you go with Medicare Advantage.


If you are still unsure you might want to check out this simple wizard to help you decide if Medigap or Medicare Advantage is right for you.

If you need help along the way contact our licensed agents at 800-930-7956.



Comments and Questions

Click to leave a Comment

  • Comment from siaosi on May 25, 2016

    So is it a lot more money up front, but ends up saving you money in the end if you have big procedures happen. I am just a little lot on how it all works. Does Medigap cover just as many doctors as medicare does?

    MEDICOVERAGE AGENT RESPONSE
    Siaosi,

    Medigap plans have the identical network of doctors, hospitals, and medical facilities as Original Medicare. If you need help finding a Medigap plan in your area, call one of our Senior65 licensed independent insurance agents at 800-930-7956.

    -Chris from http://www.medicoverage.com/


  • Comment from Darlene on April 20, 2016

    Both plans have their own importance. Both are related with Medicare supplemental insurance and Medigap policies.
    Informative content
    Keep It Up!..


  • Comment from Kimberly on February 12, 2016

    I have a question from a provider’s office.  We cannot get a straight answer from Medicare!  We are in network with Medicare, but are about to terminate our contract with the insurance provider.  I understand that if a patient has Medicare as primary and that provider as a supplement plan, they are required to provide that coverage, even if we are not contracted with that specific provider.  The question I can’t get a solid answer on is this: If a patient has a that same provider, but through a Medicare Advantage plan, and we are in network with Medicare, but not that provider, will they still receive the same benefits and coverage as if it was a straight Medicare plan?

    MEDICOVERAGE AGENT RESPONSE
    Kimberly,

    While all Medicare Advantage must cover the same benefits as Original Medicare (however, they can cover them differently), the plans work as HMOs or PPOs, and have specific networks they must work in. So, if a patient has Medicare Advantage and your facility is not contracted with the insurance provider, then you would be considered out of network, just as if they had an HMO or PPO with individual coverage. The patient would either pay out of network cost (PPO) or 100% out of pocket (HMO) to get services at your facility.

    -Amy from http://www.medicoverage.com/


  • Comment from JJ on January 31, 2016

    you told Alan in OR this regarding switching providers for Medigap plans:    “In Oregon, you have the Medigap Birthday Rule. This means every year you can change your plan to any Medigap plan with equal or lesser benefits, without having to answer medical questions”.  I live in Washington sate- how about us in WA? How do people find this answer in regards to their state? Thank you.

    MEDICOVERAGE AGENT RESPONSE
    JJ,

    In Washington State there is not a Medigap Birthday Rule. Outside of your initial enrollment period or Special Enrollment Period, you may be required to answer medical questions.

    -Chris from http://www.medicoverage.com/
    -


  • Comment from jon murray on January 28, 2016

    I’m trying to figure out if I need to sign up for Parts A and B with Social Security before I buy a medigap plan. Or does buying Plan F or G enroll you? I’m just about to turn 65.
    Thanks for your clear informative site.

    MEDICOVERAGE AGENT RESPONSE
    Jon,

    You do need to enroll in Medicare Parts A and B to be eligible to enroll in Medigap. However, most people are automatically enrolled in Original Medicare and will receive their red, white, and blue card about three months before their birthday. In the meantime, you can get a Medigap quote now.

    -Amy from http://www.medicoverage.com/


  • Comment from emma murrey on January 05, 2016

    I have a humma ppo plan and this year my medicare deductible was raised from $104.90 to $124.90 and why is that?

    MEDICOVERAGE AGENT RESPONSE
    Emma,

    We totally understand your confusion. Just want to clarify one thing, I’m pretty sure you mean your monthly premium was raised to $121.80, not your deductible (although that was raised, as well). The premium increase is for new Part B enrollees and for those enrolled before 2016 who do not pay their premium through Social Security (if you pay through Social Security it would still be $104.90 a month). Hope this helps explain it.

    -Amy from http://www.medicoverage.com/


  • Comment from G. D. Rhodes on November 24, 2015

    I’m focusing on medicare excess charges. I believe they are coverd 100% by F & G Supplemental plans, but I have been unable to determine if there are Advantage plans which cover 100% medicare excess charges. Can you tell me which plans cover excess medicare charges.   

    MEDICOVERAGE AGENT RESPONSE
    G.D.,

    There are no excess charges with Medicare Advantage plans. The reason for this is excess charges are only applied when you are enrolled in Original Medicare and do NOT have Medicare Advantage, and you see a doctor that does not accept Medicare assignment. Hope this helps!

    -Amy from http://www.medicoverage.com/


  • Comment from Lucy on November 16, 2015

    I am considering purchasing a supplement plan during the 2015 open enrollment to be covered starting January 2016.  I currently have a and b original medicare.  I have cataract surgery scheduled for January 2016.  Will my supplement plan cover me or is there a waiting period for coverage.

    MEDICOVERAGE AGENT RESPONSE
    Lucy,

    Thank you for your question. First thing first, Medicare’s Open Enrollment is not for enrolling in a Medicare Supplement plan. Now, that doesn’t mean you can’t enroll. If you just turned 65 or if you have a guaranteed issuance period, you won’t be subject to waiting periods and cannot be denied. Now if you’re enrolling outside of either one of these two periods, you’ll have to answer medical questions, and can be denied, as well as, be subject to waiting periods. We’d be happy to help you find plans in your area, please call 800-930-7956.

    -Michelle from http://www.medicoverage.com/


  • Comment from Eliza Cranston on November 05, 2015

    Thank you for posting on supplemental medical insurance! I have medicare but I’m pregnant and not sure if I need to get some additional coverage along with it. Does medicare cover pregnancy costs? Or is there a medigap supplemental program for pregnancy?

    MEDICOVERAGE AGENT RESPONSE
    Eliza,

    Medicare does partially cover pregnancy and delivery costs, and if you have Medicare Supplement plans it can pick up the gaps that Original Medicare leaves. If you’re currently pregnant and don’t have Medigap, it most likely will impose a waiting period. If this does not work for you, you may want to consider enrolling in a Medicare Advantage plan. Please call us at 800-930-7956, so, that we can better help you with this.

    -Amy from http://www.medicoverage.com/


  • Comment from nancy eastman on October 22, 2015

    I’ve noticed in several of these comments that questions were asked about pre-existing conditions or age in relation to obtaining a supplemental, or Medigap policy.  I understood that with the new ACA law , that the insurance companies cannot deny coverage due to either of these issues (pre existing conditions and / or age).
    First time I’ve visited this website and find it helpful and interesting.


  • Comment from MarlyneBarrett on October 20, 2015

    I am so happy to finally see a site that is honest with seniors about Medicare Advantage Plans. So many seniors are being pushed into Medicare Advantage without being told about what they will pay if they are hospitalized. They are also not being told that they cannot get out of Medicare Advantage if they develop a serious illness. I was in Medicare Advantage until I did my research. Also a lot of insurance companies do not offer the supplement “G” plan because they make more money with the “F” plan. Yet with the exception of the $147.00 deductible the “F” and “G” plans are identical.  In addition,  the “G” is less expensive.  Seniors do your homework before you go into a Medicare Advantage Plan ,
    it might not be what you think it is.
    Thanks for such a great and honest site.


  • Comment from Charles A. Crum on October 17, 2015

    I have not read all the comments, so maybe this has already been pointed out, but you have a serious and potentially very confusing typo at the end of the third to last paragraph of your analysis - the paragraph starting “Pay Later.” There is a reference to “Medigap Advantage.”  There is no b such thing and this error should be corrected in your presentation.

    MEDICOVERAGE AGENT RESPONSE
    Charles,

    Great catch! It’s been changed. Thanks for letting us know.

    -Chris from http://www.medicoverage.com/


  • Comment from Alan on October 15, 2015

    I live in the Oregon, and will be turning 65 in January 2016, so I’m looking at my options regarding Medicare, Medicare Advantage, and Medigap. I’ve been inform by one insurer that if I enroll in a Medigap plan, that I can continue with Medigap as long as I pay the premiums, without being turned down for any future health issues that may arise. May question is this: If I decide to change insurers for the Medigap plan in the future, would this constitute an interruption in my insurance and require me to answer health issues at that time?

    MEDICOVERAGE AGENT RESPONSE
    Alan,

    Good news for you! In Oregon, you have the Medigap Birthday Rule. This means every year you can change your plan to any Medigap plan with equal or lesser benefits, without having to answer medical questions. Hope this helps!

    -Chris from http://www.medicoverage.com/


  • Comment from Marlene on October 14, 2015

    I am a healthy 65yo resident of FL (snowbird) on one cheap generic drug and have narrowed my Medicare supplement to a Medigap plan F ($220/mo) or F-High Deductible ($80/mo) as I occasionally travel internationally.  My pension is supplementing my healthcare costs to an HRA to a tune of $300/mo.  Any advice as to which plan to choose?

    MEDICOVERAGE AGENT RESPONSE
    Marlene,

    Thank you for your question. Both are great options for Medicare Supplement, now you just want to consider a few factors: 1) If you don’t have health issues currently, while you’ll have a low premium with Medigap HD F, your plan’s coverage basically only works as emergency coverage since you have to meet that high deductible before it kicks in 2) If you have health issues now, Medigap High F’s premium and deductible can end up costing you more than Medigap Plan F. Hope this helps!

    -Jacima from http://www.medicoverage.com/


  • Comment from Sally Sell` on October 14, 2015

    I travel a lot out of the States (I live in Richmond Cityrequ Va) and wonder if any of the Medicare Advantage Plans cover foreign travel.  Also, which supplemental plans from Richmond City cover foreign travel?

    MEDICOVERAGE AGENT RESPONSE
    Sally,

    Good questions. The Medigap part of your question is easy to answer: 6 out of 10 Medigap (Medicare Supplement) plans cover foreign emergency care. The Medicare Advantage part of your question is a bit more complicated. Since MA plans are not standardized we’d need more specific information to find this out for you. Please call an agent at 800-930-7956. Hope this helps!

    -Amy from http://www.medicoverage.com/


  • Comment from Lucy on October 14, 2015

    I am 67 years old.  I have original medicare A & B. I want to purchase a Medigap Plan.  I have no chronic illness and only take a generic drug for a slightly elevated cholesterol and a genric drug for occasional premature heartbeats.  Will they charge me more because I am 67? Can they deny me for these minor health issues?

    MEDICOVERAGE AGENT RESPONSE
    Lucy,

    Thank you for your question. Since you are past your Medigap initial enrollment period, you will have to answer medical questions, and, unfortunately can be denied coverage. As for the rate you will receive that will depend on the company’s rate policy. Hope this helps!

    -Michelle from http://www.medicoverage.com/


  • Comment from Liviu Leahu on October 05, 2015

    I turn 65 in 01/2015 and I am still working and have a good insurance from my work and plan to continue to work for a while.
    When I will be retiring can I still get Medigap?

    MEDICOVERAGE AGENT RESPONSE
    Liviu,

    If you continue with qualifying job-based insurance, and you delay Part B coverage, your Medigap initial enrollment period will begin when you enroll in Part B (no matter the age). Plus you’ll save the Part B premium. (Remember to always check with HR and your current insurance company to ensure that your plan qualifies).

    -Amy from http://www.medicoverage.com/


  • Comment from Susan on July 25, 2015

    Am I correct to assume that if a doctor participates in original Medicare, the doctor also defaults to participating in Medicare Supplement plans too?  (I know that the “assignment” is another question to ask the doctor.)

    MEDICOVERAGE AGENT RESPONSE

    Susan,
    You are correct! If Original Medicare works with a doctor or facility, then Medigap works with it (unless it’s Medigap Select (which are rare and work like an HMO plan)).
    -Chris from http://www.medicoverage.com/


  • Comment from Lily on July 21, 2015

    I am trying to decide whether to go with BCBS’s PPO or original Medicare with BCBS as a supplement.  (I need one of those so I can have coverage in FL AND CA.)  In any case, I may be going in for knee surgery soon and I want to know, if I have the surgery before I retire and go on Medicare (September 2015) , will the insurance company hold the surgery against me in some way or reject me because of it?  Will my Medicare premium be higher because of it?  Or should I wait to do the surgery after I’ve already applied and been accepted in one of the Medicare Plans?
    Thanks.

    MEDICOVERAGE AGENT RESPONSE
    Lily,
    Good questions. If you enroll when you turn 65 and first eligible for Part B, you should not have any waiting periods or preexisting condition issues when you enroll in Medigap. For Medicare Advantage you can always enroll regardless of preexisting conditions. (You’ll want to check to see if there is a waiting period in your state to cover preexisting conditions).


    If you need help choosing between a Medigap and Medicare Advantage plan please call us at 800-930-7956.

    -Eric from http://www.medicoverage.com/


  • Comment from Chas Glass on May 17, 2015

    I live in Washington State.  Quotations for Advantage Plans were more expensive than the supplemental plans even after including my $2,000 gap deductible and separate Rx plan.  Prices for Advantage plans have increased dramatically in recent years.


  • Comment from Bev on May 05, 2015

    I’m in Arizona and wondering if the Humana High-deductible Plan F includes Silver Sneakers membership. Zip code is 86303.  Thank you.

    MEDICOVERAGE AGENT RESPONSE
    Bev,
    Thanks for getting back to us. Per the Silver Sneakers site, it appears that all Humana plans in Arizona offer the Silver Sneakers program. Get your gym on!
    -Amy from http://www.medicoverage.com/


  • Comment from Bev on May 04, 2015

    Does my Humana high-deductible Plan F include Silver Sneakers?

    MEDICOVERAGE AGENT RESPONSE
    Bev,
    Great question! Most Humana plans do offer the Silver Sneakers program; however, unfortunately, without knowing which state you’re in we couldn’t answer this question with certainty.  Please write back with your state and we’ll let you know the answer.
    -Amy from http://www.medicoverage.com/


  • Comment from lynn reed on March 31, 2015

    Can a medigap insurer increase premiums for a group of people based on a medical condition occurring after the policy has been in effect?

    Thanks for your help.

    MEDICOVERAGE AGENT RESPONSE

    Lynn,
    Thank you for your question. Medigap does not increase individual premiums based on medical conditions diagnosed after the effective date. If you have any further questions,
    please call 800-930-7956..

    -Michelle www.medicoverage.com


  • Comment from Johnb860 on March 09, 2015

    This web site really has all the information and facts I wanted about this subject and didn’t know who to ask.


  • Comment from Marla on February 17, 2015

    My husband had heart bypass and cancer in 2012.  He turned 65 the end of January.  He signed up for medicare part A and B. Now we are rethinking that he should Sign up for medigap and Part D.  Can we still do that and if we can will we have problems because of his past medical history?

    MEDICOVERAGE AGENT RESPONSE
    Marla,
    Thank you for your question. Your husband should still be within his Medigap initial 6-month enrollment period (begins the 1st day of the month he turns 65 and eligible for Part B). This means preexisting conditions should not apply. Please call us at 800-930-7956 for further questions.
    -Amy www.medicoverage.com


  • Comment from Dan on December 25, 2014

    I’ve just turned 65 and am very healthy with no prescriptions or chronic conditions, although of course that could change as I age.
    1. Am I correct that postponing Part D Drug enrollment until I need it makes sense, because the premium penalty is so slight compared with postponing Part B?
    2. The High Deductible Plan F seems like the best bet for someone who doesn’t see the doctor that often, but would switching to Standard Plan F in, say, 10 years require a medical evaluation then?
    Thanks for answering questions with so much real-world experience!

    MEDICOVERAGE AGENT RESPONSE

    Dan,
    Welcome to the 65 and over club! Also thank you for your questions.
    1) The Part D penalty can really add up: 1% for each MONTH that you are not in enrolled but qualified. If the penalty is not prohibitive to you, you can enroll late, however, most of our clients enroll when they are first eligible.
    2) If you wanted to switch to Plan F in ten years, generally you would have to undergo medical underwriting. We suggest if you think you’ll want any specific Medigap plan down the line, choose it when you’re first eligible.
    Hope this helps and happy holidays!
    -Chris http://www.medicoverage.com


  • Comment from Michaele on December 10, 2014

    I have been trying to research these plans for 3 months. I am new to medicare. This is the only site which I have found that is informative and somewhat reduces the confusion.
    I read that all Medigap plans are alike and the differences are the pricing.
    I have been told that Physicians Mutual of Omaha has
    more coverage under plan F than other insurance companies. Of course it costs more. Do you know if that is the case?

    Thanks from all of us for this site.

    MEDICOVERAGE AGENT RESPONSE:
    This is news to us.  One insurance company offering better Medigap benefits (or more coverage) than the others doesn’t match our understanding of how these highly regulated plans work. We would love to review these claims as we are highly dubious. 

    Here is our understanding of how Medigap insurance companies compete after helping people in this space for 10+ years:

    Better Rates: Yes. Better Service: Yes.  Better Coverage: No

    Hope that helps
    -Chris from www.medicoverage.com


  • Comment from Sheila on December 03, 2014

    My husband is 67 and very healthy. No rx’s and he exercises daily.
    I want hime to inrole in a medigap plan because we don’t know what the future will be.
    He says it not worth the money since he only works part time and we have little savings.
    He has medicare part a and b.
    What would you do in this circumstance?

    MEDICOVERAGE AGENT RESPONSE

    Sheila,
    Thank you for your question. We totally understand you desire to have him enroll in a Medigap plan for the “what ifs” and we understand his budgetary concerns. There are some lower priced Medigap plans available that will make you both happy. We suggest that you contact an agent at 800-930-7956 so that we can find a plan to work for you.
    -Chris www.medicoverage.com


  • Comment from Clark on November 26, 2014

    I am concerned with coverage during travel. What are you likely to be liable for should you be injured or become ill while traveling and require either medical attention or ambulance transport to a medical facility. I have heard horror stories about injuries requiring air transport to facilities out of network, then transport home.

    Great site, thanks

    MEDICOVERAGE AGENT RESPONSE

    Clark,
    Thanks so much for the compliment. It depends where you are traveling and which type of coverage you have. Medigap plans offer nationwide coverage, and some Medigap plans cover foreign emergency healthcare. While most MA plans do not cover you while you while you travel in the US unless it’s an emergency, as well as most don’t cover foreign travel. Since this is a concern of yours call 800-930-7956 to learn which plan is right for you.
    -Chris http://www.medicoverage.com


  • Comment from Nancy on October 04, 2014

    I have a PFFS Medicare Advantage Plan.  I was diagnosed with Colon Cancer in May, 2013, had surgery and chemo, and my 1 year anniversary testing showed no recurrence.  This all cost me one heck of a lot of money. 

    I would like to switch to a Medigap policy but will I be rejected because of a pre-existing condition? Would it help if I stayed with the same carrier, Humana?  Can I expect it to cost another heck of a lot of money?  Will my ‘condition’ force me to stay with the PFFS Advantage Plan?

    Thanks for all the terrific information you are providing.

    MEDICOVERAGE AGENT RESPONSE

    Nancy,
    Thank you for your questions. Generally speaking you have one guaranteed enrollment period for Medigap and that is when you turn 65 and first eligible for Part B. If you have passed this window you may or may not find a plan to cover you.

    However, Medicare open enrollment begins on October 15th. At this time you can switch to any other Medicare Advantage plan regardless of preexisting conditions, and in some states you may qualify for a Medicare Special Needs plan. You may be able to find a different Medicare Advantage plan that might save you money moving forward.  Please call us at 800-930-7956 if you have any further questions.
    -Michelle from http://www.senior65.com


  • Comment from Renee on September 09, 2014

    I’m doing research for my mom. She has medicare and had additional insurance through her retirement from AT&T. She is on several prescription drugs. I think the Medigap plan seems to be better with the exception that her medications aren’t covered. Are there any additional prescription drug plans that we can add? Or how do most people handle their medicine? Pay out of pocket?

    MEDICOVERAGE AGENT RESPONSE

    Renee,
    Thank you for the questions. There are separate prescription drug plans available if she decides to enroll in a Medigap plan. Most people who enroll in Medigap also enroll in a Medicare Plan D drug plan. For further questions call 800-930-7956 to speak with an agent directly.
    -Amy http://www.medicoverage.com


  • Comment from Sharita Termeer on August 01, 2014

    Properly just considered i’d say howdy. Terrific web site Ian.


  • Comment from Pat Smith on July 23, 2014

    I can change my state retirement insurance when I start receiving Medicare to a much lower cost than what I pay now.  It will be the same coverage but Medicare would be primary.  I would have no deductibles.  Is this considered a supplemental (Medigap) policy?  Which is better, staying with my same coverage (higher premium than what I have seen other Medigap coverage) or getting a regular Medigap policy?  I have to get a couple of MRIs every year along with medicines I take daily.  I have been hopitalized 2 times in the past 4 years, once for 2 1/2 weeks and another for 5 days.  I also get infusions on occasion. Anyone have any input?

    MEDICOVERAGE AGENT RESPONSE

    Pat,
    Thank you for your questions. Just to confirm: a retirement insurance plan is NOT a Medigap policy, but can sometimes be a secondary payer for Medicare services. Since you have a very specific case it is best that you call 800-930-7956 so that an agent can help you make the right decision.
    Jacima from www.medicoverage.com


  • Comment from Dave on July 08, 2014

    I have not seen any discussion on dental plans.Any comments?

    MEDICOVERAGE AGENT RESPONSE

    Dave,
    Thank you for your question. Neither Medigap or Medicare Advantage offers dental so it’s isn’t factored in on this page.  Visit our sister site http://www.senior65.com to learn more about Senior Dental Quote or call 800-930-7956 to help you understand your dental options.
    -Eric from http://www.senior65.com


  • Comment from mary jo gabiam on June 27, 2014

    I’ve learned a lot from your site. Thank you. I have one question: why do I not hear more about Medigap plan G? In my case, the monthly premium would be about $30 less with plan G than with plan F, the only difference being that I would have to pay the annual deductible. So they come out almost the same. Just wondering if I’m missing something. Thank you.

    MEDICOVERAGE AGENT RESPONSE

    Mary Jo,
    Thank you for your question. You aren’t missing anything. The only difference between Medigap Plan F and G is that Plan F also covers the Part B deductible ($147 in 2014).  I think that G isn’t discussed as much because more companies offer F than G so there are usually more options. 
    Call 800-930-7956 and we can help you decide which plan is the most cost effective.
    Michelle from www.medicoverage.com


  • Comment from C Beckner on May 06, 2014

    I am applying for a supplement for Medicare part B and the plan looks good but it has a lifetime cap of $175,0000.  Is this not a good thing to have a cap. (It is through General Electric)

    MEDICOVERAGE AGENT RESPONSE
    C Beckner,
    Thanks for your question. We are unfamiliar with the GE part B plan with a $175,000 cap.  We suggest that you give us a call at 800-930-7956 for help with your specific Medicare question.
    -Chris from Medicoverage.com


  • Comment from Andy on April 23, 2014

    medi-gap sounds like the way to go depending on the cost of a plan D Were just to used to a typical medicare-advantage plan


  • Comment from Robin on April 01, 2014

    So I can only purchase a Medigap plan if I have original Medicare but NOT if I have a Medicare Advantage Plan?  And if I take original Medicare and want policies to cover prescription drugs I have to purchase that as well?  I take this to mean that, if no money is not a consideration, I would take original Medicare and purchase both a Medigap policy and a prescription drug policy?

    Confusing

    MEDICOVERAGE AGENT RESPONSE
    Robin,
    Thanks for your questions. You are correct on all of the above: 1) You must have Medicare Part A and B to enroll in Medigap, 2) you cannot be enrolled in a Medigap plan and Medicare Advantage at the same time, and 3) neither Original Medicare or Medigap offer drug coverage, so you would want to look into Part D plans.  And yes….getting a Medigap plan and a Part D drug plan is usually the most comprehensive and the most expensive. Hope this helps!
    -Michelle from Medicoverage.com


  • Comment from Paris escort service on March 21, 2014

    Wow! This blog looks just like my old one! It’s on a completely different subject but it has pretty much the same page layout and design. Outstanding choice of colors!


  • Comment from Dorothy on March 15, 2014

    I am 59 and after 24 months on disability I am eligible for medicare. I will go with an advantage plan because medigap is too costly for me. However, if I want to switch to medigap at 65, will I fall under the 6 month ‘rule’ where those just turning 65 can’t be charged more or denied coverage for a medigap policy?

    MEDICOVERAGE AGENT RESPONSE
    Dorothy,
    You will have an open enrollment once you turn 65 with guaranteed approval. Hope that helps,
    Chris at Medicoverage.com


  • Comment from Jerry on February 09, 2014

    Your site is VERY helpful.

    ... we are a healthy, new to Medicare couple with no history of medical issues.  We have limited scripts (2) that are low and medium generic levels.

    Are near to choosing Advantage Plan vs. Medigap because historical medical needs have been minimal. We understand total exposure for Advantage plan is $4700 each.

    Given our generally healthy histories, low script needs and no cost for Advantage plan, we lean that direction.

    However, you indicate that if we choose a Medigap plan later that we will be penalized for that decision. Is it worth $5,000 to $6,000 more for our first year enrollment?

    We have three days to retract our enrollment in Advantage so we appreciate a prompt response, if possible.

    Appreciate your input.

    MEDICOVERAGE AGENT RESPONSE

    Jerry,
    It looks as though you have done your homework. There is no guarantee that you will be approved at a competitive rate if you try to apply for Medigap after open enrollment.  Only you can determine if the money saved on Medicare Advantage (MA)  is worth that risk.
    -Eric from http://www.medicoverage.com/


  • Comment from Judy on January 17, 2014

    I am researching medigap and advantage plans. The last agent we had to discuss medigap said that most des. Will eventually get out of advantage and then if we choose to switch from advantage to medigap we will be denied access or at a very high premium. And that advantage seniors will end up having to go to authorized clinics in years to come. Are these just scare tactics or is there any truth in this

    MEDICOVERAGE AGENT RESPONSE

    Judy,
    Great question. Medicare Advantage (MA) offers a smaller network of doctors and hospitals, whereas Medigap works with the entire Medicare network of doctors and hospitals. And if you were to decide at some point that you wanted Medigap after you’re initial enrollment period, you may be denied and charged a very high premium. Call 800-930-7956 and an agent will help you decide whether an MA plan or Medigap is right for you.
    Eric from Medicoverage.com


  • Comment from Lelia on January 06, 2014

    Nice! Just wanted to respond. I thoroughly loved your post. Keep up the great work on www.medicoverage.com . wish you luck in New Year!


  • Comment from John on December 15, 2013

    Thank you for making your site available.  My question is, when you sign up for a Medicare Advantage plan, do you pay for the plan and Medicare parts A and B?  Or do you just have to pay for the Advantage plan?  The same question applies if you purchase a Medigap plan.  Medigap cost plus Medicare Parts A and B?  Thank you.

    MEDICOVERAGE AGENT RESPONSE

    John,
    Thank you for your questions. Most seniors with Medicare do not pay a Part A premium. With Medigap you are still responsible for Original Medicare’s Part B premium. This is because it is a supplemental plan. Medicare Advantage replaces Original Medicare, and therefore whether you pay your Part B premium will vary by the insurance provider you choose. The financial benefit of Medicare Advantage is that many times MA plans do not require a monthly payment.
    -Kelly at Medicoverage.com


  • Comment from Louise on December 10, 2013

    My 85-year old mother has Medicare supplement plan with Bankers Life & Casualty. Monthly premiums now over $500.  Need to look at alternatives in NH.  Thinking Medicare Plan F option would be something to consider as she lives on social security income.  Any suggestions would be appreciated. 

    MEDICOVERAGE AGENT RESPONSE

    Louise,
    Thank you for your question. Medigap F is the most popular and comprehensive of all the Medicare Supplement plans. You can get a quote for it on our sister site at <a href=“https://www.senior65.com”>Senior65.com.
    -Chris at http://www.medicoverage.com


  • Comment from Lisa on November 25, 2013

    How much are copays or costs out of pocket normally for a MRI in advantage plans? I called Blue Cr and they will not tell me. Odd.
    Thanks!

    MEDICOVERAGE AGENT RESPONSE

    Lisa,
    Thank you for your question. Medicare Advantage plans cover services differently depending on the exact plan and specific network. Please give us a call and we can discuss how costs work.
    Chris from www.medicoverage.com


  • Comment from Joanne on November 05, 2013

    This is all so helpful and glad to get clarification between Medigap and Advantage plans - I almost made a misinformed mistake!  I still have some questions though… one is that I’ve read that Medigap Plan F is not available in Michigan and just plan A & C are the only options - is this true? Also, the difference I see between Plan C & F is that “Part B Excess” is covered at 100% and nothing for Plan C.  Can you please tell me what is Part B Excess and is this a big deal to not have it available?  Thanks!

    MEDICOVERAGE AGENT RESPONSE

    Joanne,
    Thanks for the questions. If your doctor charges more than the Medicare agreed amount that is considered a Part B excess charge. If you do not have a Medigap plan that covers excess charges, you would have to pay that additional amount out of your own pocket. On the other hand, a Medigap plan that includes the Part B excess charges benefit will pay that additional charge for you. As more and more doctors have complained about low Medicare reimbursement, we feel that this benefit will be important to have in the future.

    As for Medigap Plan F, it is available in Michigan. What you may be looking at is plans in your particular area or a provider in Michigan that doesn’t offer Plan F. Call 800-930-7956 to learn which plans are available in your area.
    -Eric from Medicoverage.com


  • Comment from Dixie Jones on October 30, 2013

    Tx for the info on your site, it is very helpful. Am I correct in interpreting the basic Medigap plan benefit of “Total cost of 365 extra hospital days in your lifetime” to be a one-time limit (not an annual limit), and if you need more than 365 days hospitalization in your lifetime, that neither Medicare, nor any Medigap policy will be of any help?

    MEDICOVERAGE AGENT RESPONSE

    Dixie,
    Thanks for your question. You are correct that the Medigap limit is a lifetime limit, not an annual limit. However, these 365 days are NOT a replacement of the 90 days you receive from Original Medicare…they are additional days.

    Read our article about how Medigap covers costs beyond Original Medicare to learn more.
    -Chris from http://www.medicoverage.com


  • Comment from Christine on October 16, 2013

    Thank you for this site!  This helps!  Yes, I am convinced that Medigap is better than Medicare Advantage.  My concern is that I don’t want to have to pay more for Part D.  I am under 65, on medicare for disability, but other than that I am reasonably healthy and do not currently have any need for prescription drugs.  Are there other options other than Part D for the occasional antibiotics or medications that I may need?


    MEDICOVERAGE AGENT RESPONSE
    Hi Christine,
    For occasional antibiotics, most of our clients use the discount drug clubs available at Target, Walmart or Walgreens. Often generic drugs are only $4.  The reason you would consider a Part D plan is to cover you if you were prescribed a much more expensive brand name drug. The cost for certain medications can add up quickly and a Part D plan can help contain costs. Also you will want to consider a Part D plan during your first open enrollment time. If you don’t sign up then you could be subject to a penalty.

    If you would like to talk about specific Part D plans, please give us a call.
    -Michelle at Medicoverage.com

     


  • Comment from susan on October 13, 2013

    My husband, 83 and I, 67 are both on medicare and have been using my husband’s University insurance as our secondary insurance policy.  Recently they want all retirees to enroll in their sponsored Group Medicare Advantage program for 396.40 a month. I am not for sure what the benefits are for this plan but we do want a plan that will step in and help out when our medicare coverage stops.  Please advise.  Susan

    MEDICOVERAGE AGENT RESPONSE
    Your situation is pretty specific.  $400 for a medicare advantage plan seems pretty pricy. Give us a call and we can discuss.
    -Chris from Medicoverage.com


  • Comment from Carol on September 29, 2013

    Very Helpful Comparison.  Thank you!


  • Comment from Linda on September 28, 2013

    My former employer is dropping their Medicare supplement plan for over-65 retirees (my husband) so we have to choose between an Advantage plan or one of the Medigap plans. 
    My husband has younger-onset Alzheimer’s, in the moderate stage.  He takes a number of prescriptions, mostly generic, but is in good physical health otherwise.  He also has a DNR in place, so very long hospitalizations are unlikely.  My understanding is that nursing home care is not covered by anyone.
    So my question is -is Medicare advantage or Medigap better for him?  Thank you.

    MEDICOVERAGE AGENT RESPONSE
    Linda,
    You are asking all the right questions. In any decision you will want to compare benefits of each plan with each plans monthly premium.  For your specific case we suggest you call us at 800-930-7956 so we can get you a quote and help you select the right plan for you and your husband.


  • Comment from terriv on July 24, 2013

    I am in the middle of trying to make a decision on insurance plans . . . your site has been most helpful!  Straight honest answers to vulnerable (and most times confused people).  The terminology is often confusing, i.e. Medigap and Medicare Supplement are one and the same, but how does an unseasoned insurance hunter know that? Or that Medigap policies are all basically the same, but strangely ... are differant prices. 
    My question is; Does one still have to pay the deductibles for parts A&B with a Supplemental policy?  Thank you. 

    MEDICOVERAGE AGENT RESPONSE

    Terriv,
    Thanks for the nice comments. It depends on which Medicare Supplemental (Medigap) plan you chose whether or not you will have to pay the part A or part B deductible.  If you select Medigap plan F then it will cover both deductibles and you will not have to pay them. If you select Medigap plan A, however, it will not cover either deductible.  Hope that helps. To get a quote and compare benefits in your area, visit our new site www.senior65.com. This site is set up to help “unseasoned” medicare shoppers so it might prove useful to you.
    -Chris from www.Medicoverage.com


  • Comment from Harry Underwood on July 01, 2013

    I am reasonably convinced medigap is the better choice than medicare advantage.  I am concerned, however, with prescription drug coverage as that is where about 90% of my expenses occur.  What can you advise?

    MEDICOVERAGE AGENT RESPONSE

    Harry,
    We agree that if you can afford it, Medigap is often the better choice than Medicare Advantage. Visit www.medicoverage.com/quote to get a Medigap quote:

    If you are concerned about Prescription drugs, you will want to get a Medicare Part D (drug) plan. To learn all about it and how to select the right plan for you, visit www.senior65.com/prescriptions

    Hope that helps!
    -Chris from www.medicoverage.com


  • Comment from krista on June 20, 2013

    we are looking into a medicare advantage plan for my mother in law. she is in a nursing home and will not be leaving there. does she even need a supplemental plan like this, or is medicare enough?

    MEDICOVERAGE AGENT RESPONSE

    Kirsta,
    First of all we want to clarify that a Medicare Advantage plan is technically not a supplemental plan. Medicare Advantage Plans cover the same benefits as traditional Medicare but they are run by a private company.  Medicare Advantage plans often have smaller networks but offer additional perks such as “silver sneakers” or additional Rx coverage.

    Without knowing all the details we could not say if a Medicare Advantage plan would be a better fit that just traditional Medicare. Give us a call at the number at the top of the page and we can discuss it with you.
    -Michelle from www.medicoverage.com


  • Comment from eddie on April 15, 2013

    I am told that once enrolled in a medigap or supplemental plan, that if you want to change to another more comprehensive plan than the one you have chosen it is very difficult, if not impossible to trade up, more often than not the insurance companies will let you trade down or laterally, but not up.

    Also, that it is very difficult to disenroll from the medicare advantage plan and that you will still need a prescription drug plan (part D)...i get more and more confused as i continue this process!

    MEDICOVERAGE AGENT RESPONSE

    Eddie,
    Thank you for your comment. Hopefully we can help shed some light on your situation. You are correct that it is easier to trade down (purchase a Medigap plan with less benefits) than to trade up. A switch to a more comprehensive plan usually requires that you fill out a medical questionnaire.

    As far as dis-enrolling from a Medicare Advantage plan, we can help you with that process. Please call us at 800-930-7956 and a licensed agent will assist.
    -Eric from Medicoverage.com


  • Comment from Kim Sullivan on February 25, 2013

    Is a social security disability participant under 65 eligible for medigap?


  • Comment from JulietWoods on February 01, 2013

    I’ve been debating whether or not to put my mom on mutual of omaha medicare supplement and this article just solidified my decision. Thanks for the info, it was very helpful!


  • Comment from Dee Butler on November 14, 2012

    I’ve done the research twice!  I have compared the cost between Medicare Advantage and Medigap Supplemental and it seems as though Medigap is the wiser choice of the two.  Yes, Medigap is more expensive, but it covers and offers more services than Medicare advantage.  If you are new to these selections you should beware of the clauses of both insurers for they do not cover any pre-existing health issues.  If you had a cold or a broken hip, neither plan will cover services needed for after care.


  • Comment from me on November 10, 2012

    My mother has had Medicare Advantage for almost 10 years. Her out of pocket costs are skyrocketing due to her failing health (Over $5500. this year!), so we are going to switch her to a medigap plan instead. There are no out of pocket expenses, and the increase in premiums is nothing compared to what she is now paying out of pocket for hospital and skilled nursing copays!


  • Comment from Maria-Angeles Rogles-Reos on November 01, 2012

    I recently became eligible for Medicare and now that I can choose plans, I am so confused!! I did not know that Medicare + Medigap is different from Medicare Advantage programs. My biggest fear is a big hospital and doctors bills that I cannot pay for them, or cannot afford medication. I almost signed up for Advantage but now feel in doubt and think perhaps Medicare + Medigap is a better choice, with a cost of maybe $2000 per year that can save me thousands if I ever need the services… Can someone please give me some input and opinion. Please!!

    MEDICOVERAGE AGENT RESPONSE

    Maria-Angeles,
    If you can afford it, Medigap is definitely the better choice for the reasons you state above. It cost more but it covers significantly more should you need it. If you would like to speak to an agent, give us at a call at 800-930-7956 x3 and we would be glad to help you compare plans free of charge.
    - Kelly from Medicoverage.com


  • Comment from Marilyn Mc on January 15, 2012

    Medicare Advantage questions: Is it really a problem to get non-emergency care if you are traveling?

    I hear that doctors may limit their number of Medicare patients. Is it generally easier to get in with a doctor as a new patient if the patient has a Medicare Advantage plan that the doctor accepts or if the patient has traditional Medicare with a Medicare Supplement policy? I’m trying to help my mom with her coverage decision.

    MEDICOVERAGE AGENT RESPONSE

    Marilyn,
    Medicare Advantage Plans are HMO’s so if you traveling out of network you may be subject to additional fees and/or may not get support for non-emergency care.  There is almost never coverage when traveling abroad.

    Access to doctors depends on the limits of the Medicare Advantage plan you select. Those who purchase Medigap plans can tap into the larger PPO network of doctors. Also some Medigap plans (like plan F) cover doctors excess charges so they will pay certain fees if you doctor charges more than traditional Medicare will reimburse.
    -Michelle from Medicoverage.com


  • Comment from lucylee on December 23, 2011

    My grandma just had open heart surgery with a medigap plan (new era).  The bill came to $110,000 but she owed nothing!  The plans work.


  • Comment from Bee Sky on November 21, 2011

    My Mother is on a Medicare Advantage Plan and has been for several years. We have been perfectly happy and it has saved her so much money.  Now one of her specialist is telling us we should change her, because if she had something serious we would have trouble getting her the care she needs with the HMO.  So I’m checking into MediGap plans and of course i get the big sale pitch (scare tactics) from the companies selling the Medigap plans.  Saying that the HMO’s only pay up to a certain amount, and then it comes back on you.  Where the Medigap policies cover everything at no charge to you period. I’m just not sure if I’m getting the sales pitch or the real facts and haven’t been able to find anything online that answers the question.

    MEDICOVERAGE AGENT RESPONSE

    Bee,
    Scare tactics are no fun. Medigap is not right for everyone but the plans are generally much more comprehensive that Medicare Advantage.  For example if you mother needed skilled nursing (which is basically inpatient rehab) most Medicare Advantage plans offer little to no additional coverage beyond the first 20 days. Medigap Plan F, however, will cover an additional 80 days of coverage.  If you needed more coverage, in additional 80 days offered on a Medigap plan, you would have to pay. While Medigap usually covers significantly more the Medicare Advantage,  the statement that Medigap coverage everything at no charge is not accurate. 
    -Kelly from Medicoverage.com


  • Comment from Cindy Farley on October 06, 2011

    I am concerned about yearly “out of pocket” expenses.  Do either Supplemental or Advantage plans offer a maximum cap?  I think that I read that Advantage plans do offer caps while there are no caps for Supplemental.  Thank you.

    MEDICOVERAGE AGENT RESPONSE

    Hi Cindy,
    That’s a good question. All Medicare Advantage plans have a Maximum Out of Pocket cost of $6,700. This doesn’t include prescription drug costs and monthly premiums and is only for services that Medicare Advantage covers but requires cost sharing from you. If it’s not covered under Medicare Advantage, you will still have to pay for it. So if you need extra skilled nursing and extra skilled nursing is not covered under your plan, then you will have to pay for it (even after you have hit your Maximum Out Of Pocket).

    Medigap plans typically do not have a Maximum Out of Pocket amount because there is no cost sharing. Most cover 100% of additional coverage (like 365 additional days in the hospital) so there is no need for out of pocket maximums. If you need more than 365 additional days in the hospital you will have to pay for it.

    Bottom line: if you are trying to gauge your financial risk, most Medigap plans cover significant more than Medicare Advantage so they are significantly less risky should you have major medical needs. 
    -Chris from Medicoverage.com


  • Comment from Anthony Garcia on July 30, 2011

    Medicare Advantage sucks. Medigap is better.


  • Comment from bokenn til on July 30, 2011

    I have just done all the research for my mother in-law and we decided to go with the medicare advantage plan. The medigap plans were much more expensive. The main thing to look for in the medicare advantage plans is if your doctors take the plans (you need to call them). Also, if you are taking perscription medications - whether they are covered or not. We checked on every perscription before applying to be sure each was covered. Most of the Advantage Plans have a “gap” or “donut hole”. This means that you are responsible for paying the full price of the medications once the cost goes over a certain dollar amount (usually $2,510). Some of the new plans (Anthem BCBS) will cover select generics even during the gap - which is a very important thing if you take a lot of meds. Just check on each medication to be sure it is covered during the gap.


  • Comment from jonathanmaccy on July 23, 2011

    Medigap plans (or Medicare Supplement plans) supplement both Parts A and B. They usually cost on average $100, and now do not include drug coverage. (some of them used to). With supplement plans, you can go to any doctor and don’t need referrals or anything like that. The Medicare Advantage plans are a fancy name for the HMOs you see. They usually have very little if any, monthly premium. They can include drug coverage. If you don’t mind the HMO, then it’s the cheaper way to go. If you prefer freedom, than you’d probably like the Supplement plan better. With the supplement plan, your still going to have to decide on a drug plan.

    MEDICOVERAGE AGENT RESPONSE

    Jonathan,
    This is a pretty good recap. I think the only thing I would add would be that Medigap plan will pay for many costs that Medicare Advantage plan will not. For example most Medigap plan will cover an additional year of hospital payments which are not covered under Medicare or Medicare Advantage plans.
    -Chris from Medicoverage.com


  • Comment from Johnny Quid on July 20, 2011

    I’d prefer Medicare, of which 97% of the money goes directly to paying for the healthcare, as opposed to some business skimming money off of the top.
    Sorry to say it, but healthcare insurance, along with education and the military, are the THREE things that the government can do better than private companies.


  • Comment from Martin42342 on July 19, 2011

    When it comes to Medicare supplemental insurance (Medigap)  there are no discernible differences in offerings between companies for like plans. A particular plan letter from one company works identically to that same plan letter from any other Medicare supplemental insurance company.

    MEDICOVERAGE AGENT RESPONSE

    Martin,
    You are exactly correct. Plan F from Aetna works exactly the same as a Plan F from Blue Cross. That is one of the few times that selecting on the lowest price makes sense. That being said, we strongly recommend you select a company has a good service record and is financially sound. Also you will want to see if the lowest cost plan will stay low or will they raise prices dramatically as you get older.

    If you need help in this arena, please contact us at 800-930-7956 x3
    -Michelle from Medicoverage.com


  • Comment from Annabelle Fischer on June 17, 2011

    Yikes - it sounds confusing.

    Medigap sounds like I will not have to worry about paying money for my future health needs (but for me it will be a little more than $100 a month. And, I have to take out a separate policy for my prescriptions).  Will I make up for that in my coming days?

    Medicare Advantage Plans - the price is right, but is the coverage?

    MEDICOVERAGE AGENT RESPONSE

    Annabelle,
    You nailed it. Medicare Advantage Plans are less expensive but their coverage will not protect you should you have serious Medical Needs.

    Medigap, on the other hand, is much more comprehensive but cost more. We always recommend Medigap if you can afford it. If you find that most Medigap plan are out of your price range you may want to look into a Medigap High Deductible plan F.  It has all the comprehensive coverage but a lower monthly premium.
    -Chris from Medicoverage.com


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