Medicare Advantage or Medigap: the basic difference

After you have Part A and Part B, most people choose one of two paths. You can't have both at once.

Medicare Advantage (Part C)

• A private plan that replaces how Original Medicare pays for your care.
• Usually has a network of doctors and hospitals (HMO or PPO), and may need referrals or prior approval.
• Has a yearly limit on what you pay out of pocket for covered care, and often includes drug coverage.
• Many offer extras like dental, vision or hearing. What's covered varies by plan.

Original Medicare with a Medigap policy

• Medigap (Medicare Supplement) helps pay costs Original Medicare leaves, like deductibles and coinsurance.
• You can see any doctor in the country who accepts Medicare, with no network.
• You pay a monthly premium for the Medigap policy, and you add a separate Part D plan for drugs.
• Buying Medigap later can be harder: outside your enrollment window, insurers in most states can ask health questions (some states give a yearly birthday-rule window).

Questions to ask yourself

• Are my doctors and hospitals in the plan's network?
• Do I travel or spend part of the year in another state?
• Would I rather pay more each month for predictable costs, or less each month and more when I use care?

Weighing Medigap plans? See Medigap Plan G vs. Plan N.