Medicare Advantage vs. Medicare Supplement
There are two options commonly used to replace or supplement Original Medicare. One option, called Medicare Advantage plans, are an alternative way to get Original Medicare. The other option, Medicare Supplement (or Medigap) insurance plans work alongside your Original Medicare coverage. These plans have significant differences when it comes to costs, benefits, and how they work. It’s important to understand these differences as you review your Medicare coverage options.
If you’re trying to decide between a Medicare Advantage (Medicare Part C) plan and a Medicare Supplement (Medigap) insurance plan, or if you’re just unsure about the benefits each program offers, here’s a quick overview of these types of plans and how they compare.
There are several different types of Medicare Advantage plans: HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), PFFS (Private Fee-for-Service), SNP (Special Needs Plan), HMO-POS (Health Maintenance Organization Point-of-Service), and MSA (Medical Savings Account). For an overview of these types of plans, please see Medicare Part C-Medicare Advantage Plans.
There are also several types of Medigap policies; for more details, see Medicare Supplement insurance plans. Some states sell Medicare SELECT policies. The rules of these policies are somewhat different from other Medicare Supplement insurance plans. For example, with Medicare SELECT, you generally have to choose a doctor within the plan’s network.
Medicare Advantage and Medicare Supplement insurance plans don’t work together; we don’t recommend that you try to sign up for both. In fact, you cannot be sold and use a Medigap plan if you enroll in a Medicare Advantage plan.
Here’s a chart that compares these two types of insurance (both sold by private companies).
|Comparison||Medicare Advantage||Medicare Supplement|
(premium, copayment, coinsurance, out-of-pocket maximum)
|Provider choice and availability||
|Prescription drug coverage||
||Not included. If you want this coverage, you may want to consider enrolling in a stand-alone Medicare Part D prescription drug plan.|
|Do benefits change? Is the plan renewable?||Benefits may change yearly. You usually remain in a plan unless you disenroll during the Annual Election Period (AEP) or Medicare Advantage Disenrollment Period.||Benefits don’t generally change. Guaranteed renewable as long as you pay the premium and you were truthful on the application. No Annual Election Period (AEP) for Medigap plans. However, if you drop this plan, you might never get it again.|
|For whom it works best||
|How to comparison shop||Plans are not standardized. You can use the plan comparison form on this page, contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or at Medicare.gov.||10 types of Medigap plans are standardized in 47 states; each plan is labeled with a letter (such as Plan B). Once you decide which plan you want, you can compare different companies offering the same plan. For example, if you choose Plan B, you can look at the prices and any extra options that different companies might have for Plan B. You may also want to choose a health insurer you’re already comfortable with, or you can shop around for your best price — it’s up to you. You can use the plan comparison form on this page, or visit Medicare.gov.|
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