Medicare Advantage vs. Medicare Supplement
Choosing between a Medicare Advantage plan and a Supplement plan (Medigap)
Original Medicare Parts A and B provide important health care coverage but don’t cover everything. Original Medicare does not cover most prescription drugs, dental care, vision care, hearing aids, or gym memberships. It also doesn’t include travel coverage or extra benefits that can help you live healthier and stay independent. In addition, you have to pay deductibles and copays for your care with no annual limit on your out-of-pocket costs.
That’s why most people choose additional Medicare coverage to help fill these gaps. The two most common forms of Medicare coverage are Medicare Advantage plans (Part C) and Supplement plans (Medigap). Compare these options below to see which one is best for you.
Supplement vs. Medicare Advantage plans
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Supplement plans cover all or most of the Part A and B out-of-pocket costs that Original Medicare does not cover. Supplement plans:
- Are offered by private insurance carriers.
- Do not cover most prescription drug costs. You must enroll in a separate Part D. prescription drug plan to avoid penalties.
- Provide access to any doctor who accepts Medicare.
Medicare Advantage plans provide Part A and B benefits in place of Original Medicare. Medicare Advantage plans:
- Are offered by private insurance carriers and are sometimes called "Part C".
- Include Part D prescription drug coverage in most cases.
- Have a network of doctors and hospitals that you use to receive care. It’s important to make sure your doctor participates in the plan’s network before joining a plan.
Both Medigap and Medicare Advantage help cover additional costs that are not covered by Original Medicare, but there are key differences to consider. If you are trying to decide between a Medicare supplement (Medigap) plan and Medicare Advantage Plan (Part C), you should consider these questions:
- Would you like to have added benefits such as routine vision, dental, and hearing at no extra cost?
- Would you rather buy a separate prescription drug plan or get drug coverage included in your plan?
- Would you rather pay more in monthly premiums and have lower out-of-pocket costs for services you receive or pay a low or $0 monthly premium and copays for services as you use them?
When deciding between a Medicare Advantage plan and a Supplement plan, there are many factors to consider. Think about the cost of your monthly premium, what services or benefits are covered, and your health needs to decide what will work best for you.
Insurance cards
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Medicare Advantage Plan
1 card: Your Medicare Advantage plan card.
You can keep your red, white, and blue Medicare card in a safe place.
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Supplement Plan
3 cards:
- Red, white, and blue Medicare card
- Supplement card
- Part D (prescription drug) card
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Cost
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Medicare Advantage Plan
Medicare Advantage plans usually have lower monthly premiums.
Costs for doctor visits and other covered medical services can vary widely from plan to plan. Many plans offer an affordable alternative to Supplement plans.
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Supplement Plan
These plans typically have higher monthly premiums but lower costs for doctor visits and other covered medical services.
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Coverage
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Medicare Advantage Plan
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Supplement Plan
No additional benefits and coverage
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Ready to learn about UPMC for Life Medicare Advantage plans?
UPMC for Life is a Medicare Advantage plan available in your area. Our members have access to UPMC and a large network of additional doctors and hospitals in your community. We want to make sure you have all the resources you need to live your best life. That’s why we offer additional benefits and services that give you more than Original Medicare. Learn more about UPMC for Life Medicare Advantage plans.
Supplement vs. Medicare Advantage plans: Frequently asked questions
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There are two types of Medicare Advantage plans:
- Health Maintenance Organization (HMO)
HMO plans have a set network of participating doctors that you must use for your care. If you see a provider that is not in-network, you will pay the full cost for your care. The only exceptions to this are for urgent care, emergency care, and kidney dialysis.
- Preferred Provider Organization (PPO)
PPO plans give you coverage to see doctors in- and out-of-network. You may pay more when using out-of-network providers.
Yes, switching from a Medicare Supplement plan to a Medicare Advantage plan is easy. Make sure you’ve taken time to compare and understand the differences between the two types of coverage. You can make the switch during the Annual Election Period from Oct. 15 to Dec. 7.
Next Steps
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We can answer questions and help you choose a Medicare plan that's right for you.