Difference Between Medigap Plans And Medicare Advantage Plans

The different types of Medicare plans include A, B, C and D. Medicare part C is known as Medicare Advantage plan while Medicare plan D consists of prescription drug coverage that can be availed dependently or independently.

Medigap, on the other hand, is a plan that fills any ‘gaps’ and loopholes in your already availed Medicare Plan such as copayments at a doctor’s office, coinsurance at skilled nursing facilities and out-of-pocket hospital costs that are not covered by your Medicare plan. Medigap plan is availed concurrently with Original Medicare plan, instead of Advantage plan.

Medigap plans for 2019 are not expected to change drastically. However, Medigap plan for 2019 is to discontinue plans C and F as decided by the Congress to decrease medical misuse. Thus, now would be the right time to decide your health insurance based on your budget, unique health needs and state specific laws.

Cost

Medigap plan prevents paying larger sums of money by cutting down your costs by paying your hospital and doctor bills completely or partially. Medicare Advantage Plan, on the other hand, may not always cover the costs. Some costs might be higher than that of Original Medicare and sometimes, complete charges may incur upon you if you fail to abide by the policies.

Extra Services

Medigap very rarely covers any extra services, apart from what the Original Medicare covers. The Medicare Advantage plan sometimes covers extra services that are originally not part of the Original Medicare like eye routine, dental and hearing.

Freedom of Choice

Medigap allows you to choose your own doctor and hospital throughout United States, unless you have a Medigap Select plan which allows only a few. However, Advantage Plan offers no such choice and you must choose from their network.

Referrals

With Medigap, you do not require any referrals to see a specialist. However, with the Advantage plan, quite frequently you are required to have a referral from your primary physician.

Monthly Fees

The Medigap can have much higher monthly fee than the Advantage plan as you are charged a few hundred dollars each month along with the fee for the Original Medicare. Drug prescription plan comes with a separate cost to be paid as well.

We hope this article clarifies any confusion between the plans and allows you to make an informed decision after considering Medigap plans for 2019.