What it is
Medigap is private insurance that works alongside Original Medicare (Parts A and B). It helps pay some of the costs Original Medicare leaves behind, such as certain deductibles, copayments and coinsurance. Medigap plans are standardized and labeled by letter.
Medicare Advantage (Part C) is a different path. Private companies offer plans that replace Original Medicare for your day-to-day coverage. Many include drug coverage and extras, and most use networks of doctors and hospitals.
Here is the key difference. With Medigap, you keep Original Medicare and add a supplement. With Medicare Advantage, you receive your Medicare benefits through a private plan. Official details are at Medicare.gov.
How it’s traditionally been approached
People who choose Medigap plans often value the freedom to see any provider nationwide that accepts Medicare, with no network and no referrals. They also tend to like more predictable cost-sharing. Trade-offs may include generally higher monthly premiums, a separate Part D plan for drugs, and no routine dental, vision or hearing coverage.
People who choose Medicare Advantage often value lower premiums, an annual out-of-pocket maximum, drug coverage in many plans, and extra benefits. Trade-offs may include provider networks, prior authorization requirements, and copays for services.
Neither approach is better for everyone. Health needs, budget, travel habits, preferred doctors and comfort with uncertainty all matter. Medigap plan letters also vary in what is available: Plans A, B, D, G, K, L, M and N (and high-deductible Plan G) are sold to people newly eligible for Medicare. Plans C and F (and high-deductible F) are only for people who became eligible before January 1, 2020. Plans E, H, I and J were discontinued and are not sold today. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.
How the right licensed agent may help
A Medigap agent may help you sort through the options without pressure. A licensed independent agent can generally explain how plans differ and which carriers sell in your area. Call 1-800-MEDIGAP for more information.
A conversation is usually simple. You may be asked about your doctors, your prescriptions, how you use care, and how you feel about monthly costs versus surprise costs. There is no obligation to enroll, and an agent cannot promise a particular result.
Good questions to ask include: Will my doctors and hospitals be covered? How does the plan handle drugs? Will I need medical underwriting? Do I have open enrollment or guaranteed issue rights? What happens if I want to switch later? Rules vary by state, so confirm them with Medicare.gov, your State Health Insurance Assistance Program (SHIP), or a licensed agent.
The bigger picture
This choice touches more than money. Some people feel calmer knowing they can see nearly any Medicare provider. Others feel more at ease with a lower premium and added benefits. Peace of mind is personal.
Think about how you would feel facing a health event under each approach. If you are also looking for care providers, Providers.plus may be one place to explore. Taking your time and asking questions is a healthy part of the process.
Keep in mind
- 1-800-MEDIGAP is an independent educational directory. It is not Medicare, not a government agency, and not insurance, legal, tax or medical advice.
- Switching between Medicare Advantage and Medigap may involve medical underwriting depending on your state, timing and situation. Guaranteed issue and open enrollment rules vary and change over time.
- Medigap does not usually include drug coverage, so many people add a separate Part D plan.
- No plan is best for everyone, and acceptance or savings can never be guaranteed.
Take the next step
- Talk with a Medigap agent ↗Jeff Cline on contacts.plus — a person, not a call center.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Call 1-800-MEDIGAP for more information
Frequently asked questions
What is the main difference between Medigap vs Medicare Advantage?
Medigap supplements Original Medicare, while Medicare Advantage replaces it with a private plan. With Medigap, you keep Original Medicare and use any provider nationwide that accepts it. Medicare Advantage typically uses networks and may include extras like drug coverage.
Can I have Medigap and Medicare Advantage at the same time?
No, generally you cannot use both together. Medigap is designed to work with Original Medicare, not with a Medicare Advantage plan. Confirm your situation with Medicare.gov, your SHIP, or a licensed agent.
Which costs less, Medigap or Medicare Advantage?
It depends on how you use care. Medicare Advantage often has lower monthly premiums and an annual out-of-pocket maximum, but may have copays. Medigap generally has higher premiums but more predictable cost-sharing. A Medigap agent may help you compare options without promising savings.
Does Medigap cover prescription drugs?
No, Medigap plans do not include drug coverage today. People who want drug coverage with Medigap typically add a separate Part D plan. Many Medicare Advantage plans include drug coverage.
Can I switch from Medicare Advantage to Medigap?
Sometimes, but it depends on timing, your state and your circumstances. Outside open enrollment or guaranteed issue periods, Medigap may involve medical underwriting. Check current rules with Medicare.gov, your SHIP, or a licensed agent.
Is Medigap Plan G or Plan F available to me?
Plan G is sold to people newly eligible for Medicare. Plan F is only available to people who became eligible before January 1, 2020. Call 1-800-MEDIGAP for more information.
Educational resource. 1-800-MEDIGAP shares general information and connects people with independent licensed agents. It is not professional advice. Talk with a qualified professional about your own situation.