Medicare Advantage Or Medicare Supplement?
Both are ways to get your Medicare coverage, and neither one is right for everyone. See how they compare side by side on doctors, costs, prescriptions, and travel, so you can tell which one fits the way you live.
Two Ways To Get Your Medicare
Medicare Advantage
One plan from a private company approved by Medicare covers your hospital and medical care, and most plans include prescription drug coverage.
Original Medicare + Medicare Supplement
Original Medicare (Part A and Part B) pays first. A Medicare Supplement (Medigap) plan pays some or all of what’s left, and a separate Part D plan covers prescriptions.
Either way, you still have Medicare, and in most cases you keep paying your Part B premium.
Side By Side
How The Two Paths Compare
What each one usually looks like. Details vary by plan, and a licensed agent can check the plans we offer in your area.
| Topic | Medicare Advantage | Original Medicare + Medicare Supplement |
|---|---|---|
| How It Works | One plan from a private company covers your hospital and medical care, and usually your prescriptions. | Original Medicare pays first, your Supplement pays some or all of what’s left, and a separate Part D plan covers prescriptions. |
| Doctors And Hospitals | Most plans have a network. HMO plans usually cover only network doctors, except in emergencies. PPO plans also cover doctors outside the network, usually for more. | Any doctor or hospital in the U.S. that accepts Medicare. There’s no network. |
| Referrals And Approvals | Some plans need a referral to see a specialist, and some services need the plan’s approval ahead of time. | No referral to see a specialist, and in most cases no approval ahead of time. |
| Monthly Premium | The plan’s premium varies by plan and county. You usually keep paying your Part B premium too. | The Supplement’s premium varies by plan, company, and age. You also pay your Part B premium and a premium for your Part D plan. |
| When You Get Care | You pay copays and coinsurance as you use care. Every plan has a yearly limit on what you pay for covered services in the network. | Depending on the plan, your Supplement pays some or all of your deductibles, copays, and coinsurance, so costs are easier to predict. Original Medicare alone has no yearly limit. |
| Prescriptions | Most plans include drug coverage. | Supplements don’t include drug coverage, so you add a Part D plan. |
| Dental, Vision, And Hearing | Some plans include extra benefits like dental, vision, or hearing. What’s covered varies by plan. | Routine dental, vision, and hearing care aren’t covered. You can add a separate dental, vision, or hearing plan. |
| Travel And Moving | Emergency and urgent care are covered anywhere in the U.S., but routine care is usually limited to the plan’s area. If you move away, you change plans. | Covered anywhere in the U.S. with doctors who accept Medicare, and your Supplement moves with you. Some plans help with emergency care outside the U.S. |
| Changing Your Mind | You can change plans every year from October 15 to December 7, and once from January 1 to March 31. | You can apply for a different Supplement anytime, but outside certain situations the company can ask health questions. See “Thinking About Switching?” below. |
Medicare Advantage plans are offered by private insurance companies that contract with Medicare. Benefits, premiums, and provider networks vary by plan and location.
Medicare Supplement (Medigap) plans are standardized plans offered by private insurance companies. Availability and premiums vary by location and insurer. Not connected with or endorsed by the U.S. government or the federal Medicare program.
Which One May Fit You?
There’s No Right Answer For Everyone
These are general signs, not a recommendation. A licensed agent can look at your doctors, prescriptions, and budget with you.
Medicare Advantage May Fit You If…
- You want one plan for your medical care and your prescriptions.
- Your doctors are in the plan’s network, or you don’t mind using its network.
- You’d like extra benefits, like dental or vision, in the same plan.
- You’re comfortable paying copays as you use care, up to a yearly limit.
A Medicare Supplement May Fit You If…
- You want to see any doctor who accepts Medicare, anywhere in the U.S.
- You travel or spend part of the year in another state.
- You want costs that are easier to predict when you get care, even with a higher monthly premium.
- You’re in your first 6 months of Part B, when companies can’t turn you down because of your health.
Annual Enrollment Period
Thinking About Switching?
From October 15 to December 7, you can change how you get your Medicare, and your new coverage starts January 1. Before you switch, know these rules.
From Medicare Advantage To A Supplement
You can go back to Original Medicare, but outside certain situations, Supplement companies can ask health questions and may turn you down or charge you more. Apply for the Supplement and wait until you’re approved before you leave your Advantage plan, and add a Part D plan for your prescriptions.
Your First Year In Medicare Advantage
If this is your first time in a Medicare Advantage plan, you may have a trial right: for 12 months, you can go back to Original Medicare and buy a Supplement without health questions.
From A Supplement To Medicare Advantage
If you drop your Supplement, you may not be able to get it back later without health questions, unless a trial right applies to you.
Already Have A Supplement? California’s Birthday Rule
Each year, during the 60 days starting on your birthday, you can switch to a Supplement with the same or fewer benefits, from any company, without health questions.
Already In Medicare Advantage?
From January 1 to March 31, you can switch to a different Advantage plan or go back to Original Medicare, one time.
Your Plan Can Change Every Year
Plans can change their costs, covered drugs, and doctors. Your plan sends an Annual Notice of Change by September 30, so it’s worth a review before December 7.
Review My Plan With An AgentSpecial Situations
If You Have Medi-Cal
With Medi-Cal and Medicare together, Medi-Cal helps pay your Medicare costs, and some Medicare Advantage plans are made for people who have both. A Supplement usually isn’t needed.
If You’re Still Working
If you or your spouse have coverage from a current job at an employer with 20 or more employees, you may not need either one yet.
See Your Turning-65 ChecklistKeep Learning
Not Sure Yet? Try One Of These
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Medicare Advantage Quiz
See which benefits matter most to you and what to compare.
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Medicare Supplement Quiz
See whether Plan G or Plan N may fit your budget and needs.
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Medicare Myths Quiz
Ten true-or-false questions, with each answer right away.
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Part D Penalty Calculator
Find out if you’d pay a late penalty for drug coverage.
Compare With Us
How A Licensed Agent Can Help You Choose
We look at your doctors, prescriptions, budget, and how you like to get care, then compare the plans we offer in your area, in your preferred language, at no cost to you.
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We Learn What Matters To You
Your doctors, your prescriptions, your budget, and your plans for travel.
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We Compare Both Paths
The Medicare Advantage and Medicare Supplement plans we offer in your area, side by side.
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You Decide
We explain the tradeoffs and answer your questions. You only enroll if and when you’re ready.
Who We Are
Licensed Agents Who Take The Time To Explain
Hello Insurance is an independent Medicare insurance agency. Our licensed agents help people with Medicare understand their options and choose coverage, patiently, with no pressure, and in your preferred language.
We’re paid by the insurance companies we work with, which lets us help you at no cost. Your well-being is our top priority, so we give you honest answers, even when the answer is that you don’t need to change anything.
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