What’s the Difference between Medicare Advantage and Medicare Supplement?

If you’re looking to understand the differences between Medicare Advantage plans and Medicare Supplement plans, you’re in the right spot. As with everything else related to Medicare, the answer is complicated. So, which senior health insurance program is better for you? We’ll explain the differences here, but feel free to reach out if you want to know more.

  • Right away, know that you can only have one senior insurance program in addition to your Original Medicare.
  • You can choose between Medicare Advantage or Medicare Supplement, but not both. 
  • Also, you must be eligible to enroll in traditional Medicare to get either type of plan.

Differences Between Medicare Advantage & Medicare Supplement plans (aka Medigap)

Of all the Medicare coverage questions we get asked here at CoverageCoach, this one could seem the most complex. Let’s dive right in!

Medicare Advantage Plans — Like Original Medicare Plus More

Think of Medicare Advantage plans as an all-in-one alternative for Original Medicare, with more bells and whistles.

  • If you join a Medicare Advantage Plan, you still have Original Medicare.
  • You’ll still have Part A coverage, for hospital visits.
  • You’ll still have Part B, which is health insurance for doctor visits and ambulance rides.
  • And, you’ll gain Part D — coverage for prescription medicines.
  • Depending on the plan, you might also gain benefits like dental insurance, vision insurance, and sometimes other wellness programs like a gym membership or healthy cooking classes!

All types of Medicare Advantage policies include coverage for medical emergencies and urgently needed care.

Medicare Supplement Plans (Medigap) — Fill in the Financial Gaps of Traditional Medicare

We think Medicare.gov says it best: “Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay [some] remaining health care costs.”

  • Medicare supplements don’t have all the bells and whistles like cooking classes or yoga.
  • Nor will they cover prescription eyeglasses, hearing aids, or dental work.

These senior insurance plans are meant to address your financial needs. They help to pay the balance of what Medicare doesn’t cover.

Illustrating the Differences Between Medicare Advantage and Medicare Supplement

To get a better feel for the differences between these plans, let’s use an example. Imagine you need a pacemaker implant. It’s a routine, low-risk surgery that your doctor says is medically necessary. We’re not doctors here at CoverageCoach, so we’ll just guess that this standard surgery will cost $50,000.

  • Original Medicare will cover 80% ($40,000) of this surgery. Without any additional insurance plans, that leaves you on the hook to pay the remaining $10,000.
  • A Medicare Advantage plan (depending on which plan you choose) will probably cover 100% of the surgery, plus some physical therapy afterward and maybe an in-home nurse to visit while you recover.
  • A Medicare Supplement plan will simply cover the difference of $10,000, so you’re financially free of it. What a relief!

Deciding Between Medicare Advantage and Medicare Supplements

Your decision between a Medicare Advantage plan and a Medicare Supplement plan should be made thoughtfully. We’re not trying to push you in either direction. You’ll need to consider your budget, any known medical conditions, and the various plans in your state. CoverageCoach can help! Get in touch with us for a free, no-pressure consultation today.

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