How Does Medigap Work with Medicare Advantage?

Medigap is a Medicare supplement insurance plan that covers the gaps in coverage for people who are on Medicare. Understanding how Medigap works with your Original Medicare benefits and with Medicare Advantage can be confusing. In this article, we’ll go over some of the basics and hopefully clarify it all!

The Reality of Medicare Coverage

The whole purpose of Medicare is to provide insurance coverage for people who are over the age of 65 or under the age limit but have specific disabilities. There are three primary parts of Medicare that can make up a person’s benefits.

  • Part A – covers hospitalization and inpatient care.
  • Part B – covers physician services and outpatient care.
  • Part C – Also known as Medicare Advantage, this provides all of the benefits that Parts A and B provide through a private insurance company.

Traditionally, Medicare Plans for 2021 provides a reasonable basis for coverage. In general, you can expect traditional coverage (Part A and B) to cover 80% of your medical costs for approved medical procedures, doctors, and hospitals. However, the other 20% has to be paid out of pocket, meaning that it’s your responsibility to cover. 

The worst part is that there is no cap on the amount a person may have to pay in a year, meaning if you have emergency surgery, you’re going to pay out of pocket. Plus, if you’re going to have to have additional services such as eyeglasses, prescription drugs, or dental care, you’re not going to be covered by regular Medicare.

Thankfully, there are other options to fill this gap and stop you from having to pay outrageous medical bills. Instead, you can choose Medicare Advantage plans or purchase Medigap.

Do Medigap and Medicare Advantage Plans Work Together?

No! In fact, it’s illegal to have both plans at the same time. Instead, it’s more of a choice between the two to find the right coverage for your medical situation. They both provide supplemental medical coverage for that 20%, but the terms they offer are slightly different. Here is the breakdown between the two.

Medigap

Medigap is a Medicare supplement insurance plan that can be purchased from an insurance company to help cover the 20% of medical expenses not covered by traditional Medicare. It’s important to note that Medigap plans are standardized, which means they all must follow state laws and offer primary benefits regardless of what provider you choose.

There are some advantages, such as not needing a referral and choosing any provider that accepts Medicare. This makes Medigap ideal if you like visiting certain hospitals or physicians. However, the cost can add up quickly.

Medicare Advantage

Medicare Advantage plans, commonly called MA plans or Medicare Part C, are private insurance companies that contract with the federal government to provide people with benefits. They are the more attractive option due to the non-existent or very low premium compared to the extremely high premiums for Medigap.

Plus, there are tons of add-ons, benefits, and customizations that can be added to your Medicare Advantage plan to create a better plan than your regular Medicare coverage but also to cover other necessities such as fitness memberships or transportation to your doctor’s appointments.

Get The Medicare Advantage Coverage You Need Today

We’re here to help you with whatever questions you might have. If you want to learn more, and get expert assistance from a licensed Medicare Advantage agent, click below to be connected!

Call My Insurance Finders today to get your Medicare Advantage policy started! 1-800-801-9513