Medigap vs Medicare Advantage

Medigap vs. Medicare Advantage

Choosing between Medigap and Medicare Advantage can be a pivotal decision for retirees seeking comprehensive healthcare coverage. Let’s compare and contrast these two options to help you make an informed choice.

Two Senior Citizens Walking Side By Side

Medigap: Filling the Gaps

Cost Coverage: Medigap is renowned for eliminating most out-of-pocket costs associated with Medicare, such as coinsurance, copays, and deductibles, ensuring financial peace of mind.


Long-Term Care Assistance: While not a substitute for long-term care insurance, Medigap can extend coverage for qualifying medical services received during long-term care, including hospital stays and skilled nursing facilities.


Global Health Protection: Medigap provides limited emergency healthcare coverage when traveling abroad, with a lifetime limit of $50,000.


Freedom of Choice: Generally, Medigap allows you to retain your preferred healthcare providers, ensuring you can continue receiving care from your trusted doctors.


When to Enroll: The ideal time to enroll in Medigap is during your initial 6-month enrollment period, which begins when you turn 65 and enroll in Medicare Part B. If you miss this window, you may face medical underwriting and potential premium increases.

Determining Coverage: To decide on the right amount of Medigap coverage, consider your current health status and anticipate future healthcare needs. Your family’s medical history can also provide valuable insights.

Medicare Advantage: All-in-One Coverage

Medicare Advantage plans offer a comprehensive approach to healthcare coverage, including hospital (Part A) and medical (Part B) services mandated by Original Medicare. These plans go the extra mile by often including additional benefits like vision, hearing, and dental coverage, along with prescription drug coverage (Part D). Some even offer wellness programs, such as gym memberships, further enhancing your overall well-being. However, it’s essential to keep in mind that enrolling in a Medicare Advantage plan requires you to continue paying your monthly Medicare Part B premium, in addition to any premium associated with the Medicare Advantage plan. 


Additional Benefits: Medicare Advantage plans cover the same benefits as Original Medicare but often include extra perks like dental, vision, and hearing coverage, as well as prescription drug coverage (Part D).


Lower Out-of-Pocket Costs: Many Medicare Advantage plans feature an annual out-of-pocket maximum, potentially reducing your overall healthcare expenses compared to Original Medicare.


Convenience: Medicare Advantage consolidates all your Medicare coverage into one plan, eliminating the need to enroll in separate plans for hospital, medical, and prescription drug coverage.


No Claim Forms: With Medicare Advantage, you won’t have to hassle with claim forms; the plan pays your providers directly.


Network Providers: These plans often have provider networks, offering more care options and cost savings.


Is Medicare Advantage Right for You?: The suitability of Medicare Advantage depends on individual factors. Consider your health status, budget, preferred providers, prescription drug needs, and travel habits when deciding.

Making the Right Choice for Your Healthcare Needs


In the end, the choice between Medigap and Medicare Advantage is a highly personal one. Our dedicated specialists at Exact Benefits are here to guide you through this important decision-making process. Don’t navigate it alone—call us at (800) 360-1805 or schedule a free consultation to ensure you make the right choice for your healthcare needs.

We can Help

Schedule An Appointment

It’s important to note that each individual’s needs and preferences are different, so what works for one person may not be the best choice for another. It’s essential to compare the costs and benefits of all your options, and consult with a licensed Medicare specialist. Our highly trained specialists are eager to help you navigate these important decisions. don’t try to do this alone! Call us at (800) 360-1805 or schedule a free personalized consultation.
Happy Senior Citizen Learning About Medicare.