Comparing Medicare Advantage & Medigap

What's the difference between Medicare Advantage (Part C) and Medicare Supplement (Medigap) Plans?

Medicare Advantage, also known as “Part C”, and Medicare Supplement, also known as “Medigap”, are two options that can improve your Part A and Part B coverage. Let’s explore the differences between them.

COST-SHARING (Medicare Advantage) COST-SHARING (Medicare Supplement)
Cost-sharing varies depending on plan. Typically, a co-pay is paid for in-network care. Pays part or all of certain remaining costs after Original Medicare has paid.
PREMIUM (Medicare Advantage) PREMIUM (Medicare Supplement)
Plans may charge a monthly premium, in addition to Part B premium. Plans charge a monthly premium, in addition to the Part B premium.
Provider access (Medicare Advantage) Provider access (Medicare Supplement)
Typically, need to seek care from in-network providers for best coverage. See any provider and use any facility that accepts Medicare. (SELECT plans must use in-network providers and facilities)
Referrals (Medicare Advantage) Referrals (Medicare Supplement)
Referral requirement to see a specialist varies by plan. Typically, HMOs require referrals from primary care physician. No referral necessary for treatment by a specialist.
Other Benefits (Medicare Advantage) Other Benefits (Medicare Supplement)
Plans may cover additional services, such as vision, hearing, and dental. Additional benefits may increase premiums and/or other costs for care. Medigap typically, only covers Medicare cost-sharing. However, plans may cover other costs that Medicare does not cover at all, like 365 additional lifetime days for hospital care received when traveling abroad.
Enrollment (Medicare Advantage) Enrollment (Medicare Supplement)
Annual Enrollment Period (Oct 15 – Dec 7) can be used to pick a new Advantage Plan or switch to Medicare Advantage from Original Medicare. Open Enrollment Period (Jan 1 – Mar 30) can also be used to switch. In most states, insurance companies can only sell Medigap policies at certain times, or if certain criteria are met. Contact the appropriate SHIP or Department of Insurance for details.
Comparing Medicare Advantage & Medigap