Back to homepage

Medicare Advantage vs Medigap – Which is better?

Are you eligible for Medicare? Nearly 10,000 people turn 65 every day. Unless you are going to be insured through an employer or union plan, you would be wise to choose either a Medicare Advantage Plan or a Medicare supplement policy for your health care coverage. Your potential out-of-pocket costs with original Medicare could be financially devastating. Without either a Medicare Advantage Plan or a Medicare supplement policy you will be responsible for Part A and Part B deductibles and 20% of all Medicare-covered outpatient charges. A Medicare Advantage Plan or Medicare supplement can help with those costs.

This video Medicare mini-course was created to give you straight-forward easy to understand information so you can learn about the differences between Medicare Advantage and Medigap. Watch these video lessons so you can choose the plan that is best for your individual circumstances.

Medicare Mini-Course overview: Choosing between a Medicare Advantage Plan or a Medicare supplement policy

The Medicare Mini-Course consists of eight video lessons, each dealing with a specific topic. The lessons begin with descriptions of how plans work and progress to a comparison of Medicare Advantage and Medicare supplemental. In order to get your best Medicare plan you’ll need to know the basics. People get into trouble when they base their choice on monthly premiums alone or blindly choose a plan based on someone’s recommendation. Remember, we are not looking for a plan that is universally the best for everyone. That plan doesn’t exist. The best Medicare plan will be the one that meets your individual health needs and your budget. In addition to the eight video lessons their are six bonus videos intended to further your knowledge including a video on Medicare Part D plans and what you should know before you enroll.

Video Lesson One: What is Medicare Advantage?
This video will may be the most important. There is a lot of confusion surrounding Medicare Advantage. There are several misconceptions surrounding Medicare Advantage. The most common misconception about Medicare Advantage is believing that it is a supplement to original Medicare or that enrolling in an Advantage Plan means you are leaving Medicare. Perhaps the biggest misunderstanding regarding Medicare Advantage is the fact that it is an annual plan and can change from year to year or in some cases may not even be available.

Video Lesson Two: Medicare Advantage Eligibility and How Plans Work
In order to enroll in a Medicare Advantage Plan you must meet the eligibility requirements. The bar for eligibility is not very high. You must be enrolled in Medicare Parts A and B, continue to pay the Part B premium, live in a plan’s service area (generally a County) and not have end-stage renal disease. Medicare Advantage plans are offered County by County and the number of plans and even the features of a plan with the same name can differ from one County to the next.

Plans are administered by and you receive your benefits from private insurance companies. All benefits available through original Medicare must be included in an Advantage Plan. You may also have some benefits in your plan that are not included in original Medicare such as dental, vision or a gym membership. Advantage Plans may have a monthly premium, deductible, coinsurance or co-pays.

Video Lesson Three: Types of Medicare Advantage Plans
Not all Medicare Advantage Plans are created equal. The biggest difference between types of plans regards provider networks. Their are PPO plans requiring you to use preferred providers to get the lowest out-of-pocket cost and the more restrictive HMO plans requiring you to use only in-network providers except in emergency situations. other types of plans include HMO-POS and PFFS plans.

Some Advantage Plans are intended for specific populations. These plans are referred to as Special Needs Plans (SNP’s) and include plans for those confined to an institutions, such as a nursing home, People with certain chronic illnesses and those people who are Dual-Eligible. People who are Dual-Eligible are enrolled in both Medicare and Medicaid.

Video Lesson Four: Medicare Advantage Plan Enrollment Periods
There are certain times when you can enroll in, drop or change Medicare Advantage Plans. These are known as enrollment periods. The most popular enrollment period is the Annual Open Enrollment Period which is from October 15th through December 7th each year. If you meet the eligibility requirements you cannot be denied coverage and completing an application during the Annual Open Enrollment Period will guarantee coverage beginning January 1st. There are also a number of special enrollment periods including the Initial Enrollment Period when you first become Medicare eligible as well as many others.

Video Lesson Five: What is Medigap and How Does it Work?
In lesson five we switch gears and go in-depth to Medigap. Medigap is the official term for a Medicare supplement or Medicare supplemental as it is often called. Medigap policies are also offered by private insurance companies but instead providing the benefits like an Advantage Plan they supplement original Medicare. this means that they help pay some portion (depending on the plan) of you share of the cost for Medicare-covered services. It does not mean that they are required to pay for any services that are not covered by Medicare, although some companies may include items such as gym memberships.

Video Lesson Six: Medicare Supplement Benefits Chart
Medigap includes 10 standardized plans and a high deductible option for Plan F. Plans are designated by letters: A, B, C, D, F, G, K, L, M, & N. Standardization means for instance that Plan F will include the same benefits no matter which company sells it. When researching plans you should look at more than one company. Comparing Medicare supplement plans is much easier than comparing medicare Advantage Plans. It’s important to note that legislation that will become effective in 2020 will alter your plan options and speaking with an insurance agent about how this may effect you is prudent.

Video Lesson Seven: Times When You Can Buy a Medicare Supplement
Just as there are times when you can enroll in a Medicare Advantage Plan the same is mostly true with Medicare supplements. Enrollment periods include the Open Enrollment Period when you are both Medicare-eligible and enroll in Part B and a Guaranteed Enrollment Period when you can buy a supplement regardless of your health. Guaranteed Enrollment is triggered by a number of events. Also when eligible, you can apply for a supplement but may have to undergo an underwriting process.

Video Lesson Eight: Choosing a Medicare Plan: Medicare Advantage vs Medigap

There are several factors to consider when choosing between a Medigap policy and a medicare advantage Plan. Three things to consider include your current current health, you budget and your lifestyle. For example, if you require frequent medical care and can afford a supplement you may come out better in the long run. If you budget is extremely tight you may have no choice but to enroll in a Medicare Advantage Plan. Some Medicare Advantage Plan include Part D drug coverage and have $0 premiums. Your lifestyle is primary an issue regarding plans that require that you stay within a network. If for instance, you travel frequently an HMO plan may be too restrictive.

To get more information check out my eBook, Medigap vs Medicare Advantage: Follow These 5 Simple Steps and Get the Best Medicare Plan… Guaranteed!