Medicare Advantage or Medicare Supplement?

Medicare Supplement (Medigap) and Medicare Advantage (Part C) are two different types of plans designed to help cover the costs not paid by Original Medicare (Part A and Part B). Here are the key differences between them:

1. Coverage and Structure:

   - Medicare Supplement (Medigap): These plans are sold by private insurance companies and are designed to fill the "gaps" in Original Medicare coverage, such as copayments, coinsurance, and deductibles. Medigap plans do not provide standalone coverage but work alongside Original Medicare. They do not cover prescription drugs, so beneficiaries often need a separate Part D plan for that coverage.

   - Medicare Advantage (Part C): These are all-in-one plans offered by private insurance companies that contract with Medicare. They provide all the benefits of Original Medicare (Part A and Part B) and often include additional benefits like prescription drug coverage (Part D), vision, dental, and hearing services. Medicare Advantage plans have their own network of doctors and hospitals, and beneficiaries may need to use in-network providers to receive the lowest costs.

2. Choice of Providers:

   - Medicare Supplement: Beneficiaries can see any doctor or specialist that accepts Medicare, giving them broader access to healthcare providers nationwide.

   - Medicare Advantage: These plans typically require beneficiaries to use a network of providers. They may need referrals for specialists and have limited options for out-of-network care, except in emergencies.

3. Cost:

   - Medicare Supplement: Beneficiaries pay a monthly premium for both the Medigap policy and Part B. These plans tend to have higher premiums but lower out-of-pocket costs for services.

   - Medicare Advantage: Often, these plans have lower monthly premiums compared to Medigap plans and may include additional benefits. However, beneficiaries might face higher out-of-pocket costs when accessing healthcare services.

4. Enrollment:

   - Medicare Supplement: There is an open enrollment period that starts when a beneficiary is 65 and enrolled in Part B. During this period, beneficiaries can purchase any Medigap policy sold in their state without medical underwriting.

   - Medicare Advantage: Beneficiaries can enroll during the initial enrollment period for Medicare, during the annual open enrollment period (October 15 to December 7), or during special enrollment periods if they qualify.

In summary, Medicare Supplement plans provide additional coverage to Original Medicare with broad access to providers and typically higher premiums, while Medicare Advantage plans offer a bundled alternative with extra benefits, network restrictions, and potentially lower premiums.