Medicare Advantage vs. Medigap:

Which Is Right for You?

Introduction

When you become eligible for Medicare—usually at age 65—you’ll face an important choice: Medicare Advantage (Part C) or Original Medicare + Medigap (Supplement). Both paths have benefits and trade-offs. This guide helps you:

• Understand how each option works

• Compare costs, coverage, and flexibility

• Learn which may suit different situations

• See real-world examples

• Discover how I can assist you in making the decision

What Is Medicare Advantage?

A Medicare Advantage plan is offered by private insurance companies and replaces Original Medicare (Parts A & B). Many Advantage plans also include Part D (prescription drug coverage) and often add extras like dental, vision, or fitness benefits.

Pros of Medicare Advantage:

• Sometimes lower or $0 monthly premium (beyond your Part B premium)

• Bundled coverage (medical + drugs + extras)

• Managed care structure gives more predictability

Cons / trade-offs:

• Network restrictions (you may need to stay in-network)

• Prior authorizations or utilization reviews may apply

• Benefits, networks, and costs can change annually

• Switching later to Medigap may involve underwriting (depending on your state)

What Is Medigap (Medicare Supplement)?

Medigap policies work alongside Original Medicare (Parts A & B). They cover many of the gaps—copays, coinsurance, and deductibles—that Medicare alone does not.

Pros of Medigap:

• Freedom to see any provider that accepts Medicare (no network limitations)

• Predictable out-of-pocket costs

• Policies generally renewable regardless of health changes

• Stability — fewer surprises year to year

Cons / trade-offs:

• You always pay your Part B premium plus the Medigap premium

• Monthly premiums can be higher

• Can’t combine Medigap with a Medicare Advantage plan

• If you miss your Medigap enrollment window, getting coverage later may require medical underwriting

Choosing Based on Your Situation

Here are a few key considerations:

1. Health status and anticipated needs
   If you expect high medical usage (surgeries, hospital stays, specialist visits), the stability and broader provider access of Original Medicare + Medigap may give you more peace of mind.

2. Lifestyle and mobility
   If you travel, spend part of the year out-of-state, or move frequently, Medigap’s flexibility can be invaluable. Advantage plans often restrict you to a network.

3. Willingness to review annually
   Advantage plans can change rates, benefits, and networks every year. You’ll need to shop and evaluate annually. Medigap tends to be more consistent.

4. Switching later
   If you start with Advantage and want to switch to Medigap later, you may face underwriting depending on your health and your state's rules. It’s safer to enroll in Medigap during your guaranteed enrollment period.

Real-Life Example

• Example A – Mary, age 65, healthy and low medical usage
  Mary wants simplicity, a low monthly cost, and built-in extras. A $0 premium Advantage plan looks tempting. However, she must accept network restrictions and the possibility of changes each year.

• Example B – John, age 68, with multiple chronic conditions
  John sees various specialists and expects regular medical costs. For him, Original Medicare + Medigap offers predictability and access to any provider.

How I Can Help You Decide

At Gray Owl Health Insurance Agency, I’ll:

• Compare the actual plans available in your county

• Estimate your yearly total costs under each option

• Walk you through eligibility and underwriting rules

• Help you enroll at the right time

There’s no obligation and no extra cost to you. Schedule your free consultation today, and let’s chart the best path for your coverage.

Want help comparing Advantage vs. Medigap plans in your area?