Medigap vs Medicare Advantage: What to Choose?

The Medigap and Medicare Advantage are both coverage plans that allow patients to cover up for the gaps that may be found in their Original Medicare plan. However, these two coverage plans provide different benefits for patients, and your choice will depend on the cost, provider network, and coverage deal that is offered to you. Are you wondering which of these coverage plans you should go with?

Here, we’ll take you through an exhaustive comparison to help you make an informed decision for the best healthcare benefits.

Differences Between a Medigap Plan and a Medicare Advantage Plan

The Medigap, also referred to as the Medicare Supplement is the health insurance plan that balances the Original Medicare by helping to fill the gaps in Medicare Parts A and B with financial aid for coinsurance, out-of-pocket, and deductibles.

The Medicare Advantage on the other hand is referred to as the Medicare Part C and is an alternative to Original Medicare Parts A and B. It provides benefits regarding hospitalization, medical care, and occasionally prescription drugs. The differences between these two coverage plans can be defined in the cost, coverage, and provider networks.

• Cost

When it comes to money considerations, you have to think about the cost of the plan and the probable cost of health care. On the surface level, Medigap seems to cost more because of its high monthly premium which ranges between $50 and $1,000 monthly, compared to Medicare Advantage which goes between $0 and $100 per month.

However, a deeper look into the cost shows that Medigap, despite its higher premiums has an almost nonexistent out-of-pocket cost. This is something Medicare Advantage doesn’t provide you and can, in fact, have out-of-pocket costs that go as high as $7,550.

• Coverage

Beyond the Original Medicare, each of the plans offers different extended coverages. Medigap allows you to customize your coverage to include policies of your choice that complement the type of plan that suits your needs. With Medigap, you can decide to go for deductibles, coinsurance, or out-of-pocket coverage.

On the other hand, Medicare Advantage offers a comprehensive policy that includes most medical services that you will need, from vision to hearing and dental care.

• Provider networks

The variety of physicians or providers available is also an important factor to consider. For Medigap, there’s barely any difference in provider networks. This allows you to visit any physician who currently participates in the Medicare program without the need for a referral.

Medicare Advantage on the other hand has a range of provider networks that depend on the plan you pick. The in-network and out-of-network coverage you go with include Health maintenance organization (HMO), Preferred provider organization (PPO), or Private fee-for-service (PFFS).

Which Type of Coverage Is Right for You?

When it comes to choosing between a Medigap plan and a Medicare Advantage plan, it’s important to consider your circumstances. The choice you make depends on your health care needs, budget, and how much work you intend to put into getting Medicare coverage.

A Medicare Advantage plan appears as the cheaper and more coverage-filled option. However, the downside is that you get to pay for a quota of your medical care. So if you need more health services, this plan will give you larger bills.

In contrast, a Medigap plan appears to be more expensive, but it has a chance of providing better coverage for your medical costs. If you’re dealing with chronic conditions or may require costly medical procedures, the Medigap may seem like a better deal for you.

Ultimately, the best way to decide which type of coverage is right for you is to speak with a qualified insurance agent or broker (like or many others) who can help you compare your options and make an informed decision.