Medicare Advantage vs. Medigap: Which One Is Right for You?

Should I enroll in a Medicare Supplement (Medigap) plan or a Medicare Advantage plan?

Medicare Supplement (Medigap) vs. Medicare Advantage. Which one is right for me? There’s no universal answer, but there are clear trade-offs that we can evaluate based on your health needs, lifestyle, and financial priorities. Let’s walk through the key differences and help you understand which option might suit you best.

Why Some Clients Prefer Medigap (Medicare Supplement) Plans

These are the five most common reasons clients choose Medigap:

1. Nationwide Provider Access
   Medigap plans allow you to see any doctor or hospital in the U.S. that accepts Medicare. There are no networks or restrictions, which is especially valuable if you travel or split time between different states.
2. No Referrals Required
   With Medigap, you do not need a referral to see a specialist. You can schedule appointments directly, without having to go through a primary care gatekeeper.
3. Fewer Claim Denials
   Medicare remains your primary insurance, not a private insurer. This often results in fewer denied claims compared to Medicare Advantage plans, which are managed by private companies that have more control over your care approvals.
4. Customizable Prescription Drug Coverage
   Since Medigap does not include drug coverage, you select your own standalone Part D plan. This allows you to tailor your prescription drug coverage based on your specific needs, and even change it annually during the enrollment window.
5. Predictable Out-of-Pocket Costs
   While Medigap premiums are higher—often between $2,000 to $2,400 more per year than Medicare Advantage—many clients prefer the predictable costs and reduced exposure to co-pays and coinsurance, especially under plans like Plan G.

Why Other Clients Choose Medicare Advantage Plans

Now let’s explore why other clients, including our second example, prefer Medicare Advantage:

1. Low or Zero Monthly Premiums
   Medicare Advantage plans often have no premium beyond your standard Part B payment. This is a key reason many clients on fixed incomes choose this route.
2. Minimal or No Deductibles
   Many Medicare Advantage plans offer no deductible for medical services. In contrast, some high-deductible Medigap plans have annual deductibles that exceed $2,000.
3. Familiar Network-Based Care
   If you’re comfortable with HMOs or PPOs, which are common in employer-sponsored insurance, Medicare Advantage plans may feel familiar. Some clients are perfectly content with the network structure and are happy to trade some flexibility for lower costs.
4. Bundled Extra Benefits
   These plans often include dental, vision, hearing, gym memberships, over-the-counter allowances, transportation, and even acupuncture—services not typically bundled with Medigap plans.
5. Convenience and Simplicity
   With Medicare Advantage, your medical and prescription drug coverage are integrated into a single plan. This streamlines paperwork and minimizes the need to coordinate between separate providers or plans.

Are You a “What If” Type of Person?

We often ask clients, “Are you the kind of person who thinks about what could go wrong?”

If you frequently ask, “What if I get sick? What if I need to see any doctor? What if I travel a lot?” — then Medigap is often the more suitable choice. It offers greater peace of mind and access.

On the other hand, if your main concern is managing monthly costs and you’re comfortable with a managed care structure, Medicare Advantage may be a better fit.

Let’s Make the Right Decision Together

We work with more than 50 insurance carriers and are licensed in all 50 states. Our goal is to find a plan that fits your health needs, lifestyle, and budget—not one that just checks a box.

Best of all, we are paid directly by the insurance companies, not by you, so our assistance comes at no additional cost.

Whether you are enrolling in Medicare for the first time or considering a switch during open enrollment, we’re here to help you navigate this process with clarity and confidence.

Contact us today to review your options and build a Medicare strategy that works for you.