Navigating Medicare Advantage vs. Medigap
Navigating Medicare: Understanding Your Options - Medicare Advantage vs. Medigap
Welcome to The Geller Agency's first blog post! We're here to offer clear, no-cost guidance on everything Medicare. One of the most common questions we hear is about the difference between Medicare Advantage Plans (Part C) and Medicare Supplement Plans (Medigap).
Let's break it down to help you understand which might be the right fit for your healthcare needs.
At any point in this article, we’re here to offer free enrollment and Medicare support. Simply contact us to speak with an agent.
Medicare Advantage (Part C): Your All-in-One Option
Medicare Advantage Plans, offered by private insurance companies approved by Medicare, provide an "all-in-one" alternative to Original Medicare (Part A and Part B). These plans often include Part D prescription drug coverage and may offer extra benefits like dental, vision, or hearing care. Think of them as a bundled approach to your Medicare coverage.
See More: What are Medicare Parts A, B, C, and D?
Medicare Supplement (Medigap): Filling the Gaps in Original Medicare
Medicare Supplement Insurance, often called Medigap, is extra insurance you can purchase from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. These costs can include deductibles, copayments, and coinsurance.
Medicare Medigap Plans Explained, Video length 04:08.
Key Differences to Consider:
Prescription Drug Coverage: Medicare Advantage plans often include Part D, while Medigap plans generally do not. If you need prescription drug coverage and choose a Medigap plan, you'll typically need to enroll in a separate Part D plan.
Extra Benefits: Medicare Advantage plans frequently offer additional benefits beyond what Original Medicare covers, like routine dental or vision care. Medigap plans focus on covering your existing Original Medicare costs.
Out-of-Pocket Costs: Medigap plans are designed to help cover your share of costs in Original Medicare. For example, Medicare covers your first 60 days as a hospital inpatient, but you're responsible for coinsurance for days 61-90 (which will be $419 in 2025) and higher costs beyond that. Most Medigap plans help cover the Medicare Part A hospital deductible (which is $1,676 per benefit period in 2025).
Network Restrictions: Medicare Advantage plans may have networks of doctors and hospitals you need to use to get the lowest costs (like HMOs and PPOs). Original Medicare and Medigap plans generally allow you to see any doctor who accepts Medicare.
Medigap and Medicare Advantage – A Key Warning: It's crucial to understand that if you're enrolled in a Medicare Advantage Plan, it's generally illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. You also cannot use a Medigap policy to pay for your Medicare Advantage Plan's copayments, coinsurance, deductibles, and premiums.
Making the Right Choice for You
Choosing between Medicare Advantage and Medigap depends on your individual healthcare needs, budget, and preferences. Do you prefer an all-in-one plan with potential extra benefits? Or do you want the flexibility of Original Medicare with help covering out-of-pocket costs?
Need Help Navigating Your Medicare Options?
The Geller Agency is here to help!
As your no-cost Medicare guide, we can explain these options in detail, answer your questions, and help you find a plan that fits your unique situation.
Contact us today for a free, no-obligation consultation.
Let us make your Medicare journey clear and stress-free.
Sources:
https://www.medicare.gov/ - Understanding Medicare Advantage Plans, Page 19. Accessed on 6/27/2025 by Matt Foster writer for The Geller Agency.
"Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. If you’re in a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare. If you aren’t planning to drop your Medicare Advantage Plan, and someone tries to sell you a Medigap policy, report it to your State Insurance Department. If you have Medigap and join a Medicare Advantage Plan, you may want to drop Medigap. You can’t use Medigap to pay your Medicare Advantage Plan copayments, coinsurance, deductibles, and premiums." (p.19, Medicare.gov pdf)
https://www.aarp.org/medicare/faq/what-is-medigap-insurance/ - What is Medigap insurance? By Kimberly Lankford, Updated February 04, 2025AARP. Accessed on 6/27/2025, last updated February 4, 2025.
Medicare covers the first 60 days as an inpatient in a hospital, but you’re responsible for paying the coinsurance for days 61 to 90 — $419 in 2025 — and an $838 daily coinsurance after that for up to 60 lifetime reserve days in 2025. Covers some deductibles. Most Medigap plans cover the Medicare Part A hospital deductible, which is $1,676 per benefit period in 2025. Adds health benefits. Although Medicare won’t cover your hospital stay after you’ve depleted your lifetime reserve, all Medigap policies cover the daily coinsurance costs and up to 365 additional lifetime days in the hospital after your Medicare benefits are used up.
