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Choosing Between a Medicare Advantage Plan and a Supplement Plan (Medigap)


Original Medicare Parts A and B provide important health care coverage, but they don’t cover everything. Original Medicare does not cover most prescription drugs, dental care, or vision care; or include travel benefits. And, with Original Medicare, 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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What is a Supplement plan (Medigap)?

Supplement plans are offered by private insurance carriers. They enhance Original Medicare by paying all or most of the Part A and B out-of-pocket costs that Original Medicare does not cover. Supplement plans do not cover most prescription drug costs. You’ll need to enroll in a separate Part D plan. With a Supplement plan, you can see any doctor that accepts Medicare.

What is a Medicare Advantage plan?

Medicare Advantage plans are also offered by private insurance carriers and are sometimes called "Part C". Medicare Advantage plans provide Part A and B benefits in place of Original Medicare. Most also include Part D prescription drug coverage. Medicare Advantage plans generally 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 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 costs?
  • 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

Medicare Advantage Plan

1 card: Your Medicare Advantage plan card.

The red, white, and blue Medicare card can stay in your drawer.

Supplement Plan

3 cards:

  1. Red, white, and blue Medicare card
  2. Supplement card
  3. Part D (prescription drug) card
Cost

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.

Supplement Plan

These plans typically have higher monthly premiums, but lower costs for doctor visits and other covered medical services.

Coverage

Medicare Advantage Plan

Supplement Plan

No additional benefits and coverage

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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What are the types of Medicare Advantage plans?

There are two types of Medicare Advantage Plans:
  1. Health Maintenance Organization (HMO)
    • HMO plans use a network of participating hospitals and doctors for your care.
    • You must receive services from participating hospitals and doctors, except for emergency care, out-of-area urgent care, and out-of-area kidney dialysis.
    • Make sure your current doctors are included in the plan’s provider network before joining a plan.
  2. Preferred Provider Organization (PPO)
    • PPO plans offer coverage for services received both in and out of the plan’s provider network.
    • You may pay a higher coinsurance, copay, or deductible for care received outside the plan’s participating provider network.

Can I change from Medicare Supplement to Medicare Advantage?

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.

What is the difference between Medicare Supplement Plans G and N?

Medicare Supplement plans are standardized across the nation. These plans are offered by private insurance companies, but plan types with the same letter offer all the same basic benefits regardless of location.
  • Plan G offers all the same benefits as Plan F but does not cover your Part B deductible.
  • Plan N offers all the same benefits as Plan F but does not cover your Part B deductible or Part B excess charges. It also covers the Medicare Part A deductible at 50 percent rather than 100 percent.

Are there Medicare plans designed for people with chronic medical conditions?

Yes. Medicare Special Needs Plans (SNP) are a type of plan that limit membership to individuals with certain characteristics or chronic conditions. They typically provide high-quality coverage with a $0 monthly premium. Learn more about SNP plans offered through UPMC for Life.

Next Steps

Shop for Medicare Plans

Find a UPMC for Life Medicare plan that best fits your needs.

Request a Free Enrollment Kit

Request a free enrollment kit to learn about UPMC for Life plans and coverage options.

Contact Us

We can answer questions and help you choose a Medicare plan that's right for you.

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/non-contracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal.

Tivity Health and SilverSneakers are registered trademarks or trademarks of Tivity Health, Inc. and/or its subsidiaries and/or affiliates in the USA and/or other countries.

UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 through Mar. 31:
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Apr. 1 through Sept. 30:
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Saturday: 8 a.m. to 3 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Oct. 1 through Dec. 31:
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Jan. 1 through Sept. 30:
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Saturday: 9 a.m. to 3 p.m.

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Last Updated: 10/01/2019
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