Understanding Medigap vs. Medicare Advantage Plans

May 29, 2024 10:05:00

Medicare is a health insurance program that caters to aging persons at a fee. While the program provides a range of benefits and different types of coverage, it has its issues. To help with this, individuals should consider enrolling in a Medigap or Advantage plan.

What is Medicare Advantage?

Medicare Advantage, which is sometimes referred to as Part C, is offered by private insurers and is basically an individual’s primary insurance. It provides all benefits under Medicare as well as additional ones, including vision, dental, hearing and fitness coverage.

Individuals eligible for the Advantage plan include younger individuals with disabilities, those aged 65 years and older, and those with end-stage renal disease.

Most Advantage plans have a $0 premium, so individuals need to consider all their options. On average, an individual on Medicare has more than 30 Advantage plans to choose from.

What is Medigap?

On the other hand, Medigap, which is also referred to as Medicare Supplement plans, is offered by private insurance companies to supplement what original Medicare covers.

Medigap has 10 plans to pick from, with the plans offering standardized coverage and paying for different things, including coinsurance and deductibles. The estimated average premium charged per month ranges between $150 to $200.

People who are 65 years and older should consider enrolling in Medigap. It should be noted that federal regulations don’t mandate insurance companies sell policies under Medigap to individuals aged 65 and below.

So, what’s the difference between the Advantage and Medigap plans?

For starters, Medigap has global travel coverage while Advantage offers only one-stop-shop coverage. Advantage is also $0 deductible for most plans while Medigap has monthly payments that may at times be expensive.

Additionally, Medigap policies do not cover prescription medications while most policies under the Advantage plan cover prescription drugs.

Can someone switch between these plans?

Individuals who would like to switch from Medigap to an Advantage plan can do so during the open-enrollment period, which runs from Oct. 15–Dec. 7 every year.

It is important to note that those wishing to switch to Medigap from an Advantage plan will need to drop the latter and start by enrolling in original Medicare. Persons wishing to do so can drop the Advantage plan during the open-enrollment period, which runs from Jan. 1–March 31 annually.

To choose the best plan for you, individuals should consider various factors including budget, health history, medication needs and preferred benefits offered by the different providers such as Astiva Health before making a decision.

NOTE TO INVESTORS: The latest news and updates relating to Astiva Health are available in the company’s newsroom at https://ibn.fm/Astiva

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