What Is The Difference Between Medigap and Medicare Advantage?

If you have Medicare, you may have noticed that there are some treatments it does not cover. It also imposes time limits on hospitalization and ongoing treatments.

Fortunately, there are a couple of options for supplementing your Medicare coverage; Medicare Advantage and Medigap.

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Unfortunately, you cannot use both of these plans. It may be helpful to know a few facts about each of these types of supplemental insurance.

Medicare Advantage

Also known as “Plan C”, Medicare Advantage provides its customers with more comprehensive coverage. It is designed to cover the gaps in Plan A and B. Plan C is provided by a private insurance company of which Medicare has approved. The plan is funded by the United States Government and users are still considered Medicare customers.

When you choose this plan you will have all of your normal Medicare coverage, plus access to wellness programs, vision, hearing, and dental.

Medicare Advantage plans allow users to curtail certain benefits to their own personal needs. If you have a chronic condition, this can be a great advantage. The program will also cover such things as medical transportation, non-prescription medication, and even adult daycare if it becomes necessary. Some of the plans may also include prescription drug benefits.

You can qualify for Medicare Advantage at the same time you qualify for Medicare itself, so you only have to fill out paperwork once. When you have reached your maximum out of pocket expense limit, it should cover you for the rest of the year.


Medigap also offers coverage that is designed to complement a person’s Medicare plan. It assists Medicare patients in paying out of pocket expenses. It can help with costs such as co-payments, co-insurance, and deductibles.

Medigap is offered by private insurance companies. Although it is not run by the state, an insurance company must be licensed by the state to offer a Medigap plan. There are many different varieties of Medigap plans, so it is important to do your research when you select one for yourself. There are some states that have as many as 10 different plans.

As with any type of insurance, a potential customer will want to check out the list of providers and make sure that the doctor they wish to see is covered by their plan. It is also important to examine the premium that each company charges and the co-payment amount.

Medicare Advantage tends to have less expensive premiums than Medigap, but Medigap works with almost any provider that Medicare covers. Medigap covers the largest number of expenses and you are likely to have higher out of pocket expenses with Medicare Advantage.

Medigap should cover any doctor that accepts Medicaid whereas Medicare Advantage is more limited. If you travel often, Medigap may be a better option for you as Medicare Advantage limits you to doctors in your region.

Finding an Insurance Agent

Before you decide what plan is right for you, you should definitely talk to a Medicare supplemental insurance agent. A good agent should be able to provide a free consultation at your home or in their office. South Florida Medicare Specialists can help you select a plan that is perfect for you.

Getting older is hard enough without worrying if you can afford medical care. Supplemental insurance will give you the security you need to enjoy your golden years.

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