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 from Medicare Advantage to 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. |
