Medicare Advantage Versus Medicare Supplement: What You Need to Know

Approaching age 65? You may be wondering what health plan is best as you age. One option, Medicare, you’ve probably heard about. It’s a fee-for-service health plan that’s designed for people who are age 65 and older. Also known as Original Medicare, it’s offered through the federal government and covers a portion of your healthcare costs—but not all.  

Fortunately, there are alternative Medicare policies that you can buy through private insurers: Medicare Advantage and Medicare Supplement (also known as Medigap). Here we’ll walk you through the pros and cons of choosing these plans, so you can be fully informed and choose the right policy for the years ahead.

Medicare Advantage: What Is It?

Also known as Medicare Part C, Medicare Advantage is offered through private insurers and geared toward people who are 65 and older. Some people with disabilities or end-stage renal disease may qualify for Medicare Advantage too. Usually, Medicare Advantage replaces Original Medicare.

What’s nice about Medicare Advantage is it’s an “all-in-one” solution, meaning it usually covers all of your Medicare benefits, as well as some dental, hearing, vision, and wellness coverage (for example, a gym membership). Many Medicare Advantage plans also include Part D for prescription drug coverage.

Pros of Medicare Advantage:

• You can get the same benefits as Original Medicare and more
• It can include vision, dental, hearing, and gym benefits
• Many plans have a $0 deductible
• Normally there’s no copay for primary care services
• You can expect a low copay to see a specialist

Cons of Medicare Advantage

• You still need to be enrolled in Medicare Part A and Part B (Original Medicare)
• You may have a limited network, including fewer doctors, hospitals, and suppliers that are covered by your plan
• Some services aren’t covered, which may lead to unexpected out-of-pocket costs if you get sick

Medicare Supplement: What Is It?

A Medicare Supplement plan, also known as Medigap, is designed to supplement Original Medicare coverage. True to its name, it “fills in the gap,” to help cover the cost of providers and services that aren’t fully covered by a government-sponsored Medicare plan. Medicare Supplement policies are offered through private insurers, like Lumico, and can help pay for copays, deductibles, and coinsurance.

Pros of Medicare Supplement:

• A Medicare Supplement plan and Original Medicare is accepted by most doctors and hospitals in the United States.
• Because most providers will accept your coverage, it can be easier to understand and budget for medical costs.
• You never need prior authorization or a referral for certain healthcare providers or services.

Cons of Medicare Supplement:

• It may be more expensive to purchase a Medicare Supplement plan and enroll in Medicare Part A and B—but not always.
• You’ll still need to enroll in Medicare Part D for your prescription drug coverage.

That said, Medicare Supplement is an incredibly popular option among Americans—mostly because it offers great freedom in the range of providers you can visit. In fact, Nearly 81% of people with Medicare Parts A and B supplement their insurance with Medigap (Medicare Supplement insurance). When you choose a Medicare Supplement plan, you can feel confident that the providers you know and trust will most likely accept your coverage.

At Lumico, we offer Medicare Supplement insurance to people looking to extend their Medicare coverage. Take a look at our coverage information and call us at 1-855-774-4491 if you have questions. Our customer care team is here to help.