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With the tremendous cost of private insurance, especially for older individuals, Medicare can be a senior’s best friend. Unfortunately, figuring out whether it’s best to stick with the original Medicare along with Medigap or buy a Medicare Advantage plan can be confusing to say the least. The information below is designed to educate you on each option and help you determine which is best for your individual scenario:

What is Medicare Plus Medigap?

Original Medicare, such as Medicare Part A and Part B takes care of most medical services, including hospital visits. It does not; however, cover every single medical expense. Medigap is an additional measure of protection that provides coverage for those expenses that Medicare doesn’t cover.

What is Medicare Advantage?

A Medicare Advantage plan goes along with the Part B premium. Medicare Advantage plans work similar to private insurance plans and is an alternative to original Medicare. It does have an annual out-of-pocket limit and typically includes co-pays and deductibles.

How Medicare Advantage and Medigap Plans Compare?

You cannot have both a Medicare Advantage and Medigap plan at the same time. Therefore, figuring out which offers the most coverage and benefits for your individual needs is important. The following is an issue-by-issue comparison of the two types of plans.

  • Premium: On average, Medigap coverage costs about $150 to $200, monthly. It can vary based on your health history, age or both. Medicare Advantage premiums cost from $0 to $100 a month based on the plan. All enrollees pay the same amount, there is no difference for health conditions or age.
  • Out-of-Pocket Costs: Medigap has low to no out-of-pocket costs beyond the premium. Medicare Advantage include copays from $3,400 to $6,700, yearly based on the plan. However, Medigap plans can cost up to two to three times as much as a Medicare Advantage plan.
  • Choice of Doctor: Medigap allows you to go to any doctor who takes Medicare. Medicare Advantage has HMO’s, meaning the plan has PPOs and out-of-network costs.
  • When it Can be Bought: Medigap can be purchased six months after signing up for Medicare Part B coverage. You also must be at least 65 years of age to purchase. In most states, you cannot be turned down or face increased medical costs due to preexisting conditions. Medicare Advantage can be bought when you enroll in Medicare Part A and B and annually after that time.
  • Prescription Drug Coverage: Medigap does not include prescription Part D coverage, while Medicare Advantage often does include prescription coverage.
  • Cards: Medigap provides you with three cards, one colored in red, white and blue, the second is a Medigap card and the third a Part D card. Medicare Advantage usually includes just one card and does not require you to show your Medicare card.

Things to Consider Before Making a Decision Between Medigap and Medicare Advantage

You should consider whether or not your doctors are covered in a plan, what your drug costs would be and what you would have to pay for out-of-pocket when choosing between Medigap and Medicare Advantage coverage.

Both Medigap and Medicare Advantage plans come with their own advantages and drawbacks. You can read more about Medigap and get a free quote here. Hopefully, the information above has helped you determine which is the best fit for your individual needs.

 

Sources:
https://www.mymedicarematters.org/2016/05/which-better-medigap-or-medicare-advantage/
https://www.consumerreports.org/cro/news/2014/10/medigap-vs-medicare-advantage-consumer-reports/index.htm

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