Medigap vs Advantage
Critical Medicare decision.
Medigap (Supplement)
- Used with Original Medicare.
- Higher monthly premium ($150-$300+).
- Lower out-of-pocket when you need care.
- Any doctor accepting Medicare.
- No referrals needed.
- Best for those wanting predictable costs.
Medicare Advantage
- Replaces Original Medicare.
- Often $0 monthly premium.
- Must use network doctors.
- May require referrals.
- Often includes Part D + dental + vision.
- Higher copays + max out-of-pocket.
Medigap better when
- You travel often - accepted nationwide.
- Have specific specialists you want.
- Live in multiple states.
- Need lots of care - predictable costs.
- Prefer no referral system.
- Higher income (afford premium).
Advantage better when
- Stay in one area + healthy.
- Want low monthly premium.
- Doctors are in plan's network.
- Want extra benefits (dental, vision).
- Limited income.
- Don't mind referral system.
The trap
- Switching FROM Advantage TO Medigap is hard.
- Medigap can deny based on health.
- Once locked into Advantage, often stuck.
- Initial enrollment = guaranteed Medigap acceptance.
- Pick carefully at first enrollment.
- Talk to advisor.
Get unbiased advice
- SHIP - State Health Insurance Assistance.
- Free Medicare counseling.
- Independent - no commission.
- 1-800-MEDICARE - official help.
- Avoid commission-based brokers initially.
- Get unbiased view first.
Decide carefully at age 65
Your initial Medicare enrollment at 65 is the critical decision. Medigap (Supplement) Plan G is most common - covers most gaps in Original Medicare. Higher premium, lower copays. Medicare Advantage often has $0 premium but more restricted networks. Talk to free SHIP counselor before deciding. Get it right the first time.