Medigap vs. Medicare Advantage - Key Differences

Medigap vs. Medicare Advantage – Key Differences

While the Medigap and Medicare Advantage plans can each be beneficial, there are key differences between the two. Being well acquainted with these differences can help you choose the type of plan that works best for you.


The primary difference between the Medigap and Medicare Advantage plans come at a different cost. Generally speaking, Medigap plans have higher premiums than Medicare Advantage plans. However, Medicare Advantage plans often cover less expenses than Medigap — potentially resulting in more out-of-pocket expenses. You can save money by choosing the plan that makes sense for your specific conditions and lifestyle.

Choice of Physicians

One key difference that might influence your decision to select Medigap or Medicare Advantage plan is the choice of physicians they offer. Be mindful of the limitations of both plans if you have a chronic condition that requires you to see specific specialists. Medicare Advantage offers a limited selection of physicians and facilities within their network. Certain Medicare Advantage plans don’t cover out-of-network physicians at all. Some Medigap plans offer more flexibility. Both Medigap and Medicare Advantage will cover any physician or facility that accepts Medicare.


One major determinant of which plan you choose is where you are located and your lifestyle. If you live in one state and rarely travel, then Medicare Advantage might be best suited to you. If you live in more than one state throughout the year or travel frequently, then Medigap may be a better choice. Medicare Advantage plans usually offer coverage in one region exclusively. They also don’t typically offer coverage when traveling internationally. In contrast, many Medigap plans provide coverage in all 50 states and when traveling outside of the U.S.

Benefits of Medigap

medigap vs medicare advantage

Medigap bolsters Medicare plans A and B by filling in the “gaps” in coverage and providing more comprehensive options for the insured person. It covers almost all of the out-of-pocket costs in the Original Medicare plan.

Aside from having more comprehensive coverage in general, one of the top benefits of Medigap is the cost. While the premiums can be higher than Medicare Advantage, these premiums result in few to no out-of-pocket costs.

It also offers a great deal of flexibility in terms of the physician network. Generally, any physician or facility that accepts Medicare is covered by Medigap. This stands in stark contrast to the more limited network offered by Medicare Advantage.

Another great advantage of Medigap is the lack of effort involved in filing a claim. There is virtually no paperwork to deal with. Checks are automatically made to providers and facilities after Medicare pays its portion of the bill.

Benefits of Medicare Advantage

Medicare Advantage is an extension of Medicare plans A and B, offering more coverage than Original Medicare. This option is very popular because it replaces the Original Medicare Plan while still remaining affordable. It often has much lower premiums than Medigap, making it an attractive option if you don’t anticipate using it frequently. For many plans, if you hit the maximum out-of-pocket costs, the plan will cover you for the rest of the year.

Another benefit of the Medicare Advantage plan is that enrollment is simple. You qualify for the Medicare Advantage plan once you qualify for the Original Medicare plan, and enrollment occurs annually.

Most Medicare Advantage plans also include prescription drug coverage, otherwise known as Plan D. In contrast, Medigap does not offer prescription drug coverage. This means that the person being insured must purchase a prescription plan separately.

Ready to get started with your Medicare Supplement Plan? Read this overview before you move forward: Medicare Supplement Insurance – General Overview to Get You Started

By David Lasman – “Ask Medicare Dave” | President – Senior Healthcare Team | 866-333-7340

Selecting the right healthcare plan through Medicare can be overwhelming and downright stressful. Senior Healthcare Team is a nationwide resource that provides guidance and support about Medicare to seniors at no cost to them and helps them to choose the most suitable insurance plan tailored to their specific needs and budget.  Our goal is to educate and empower our clients to make the best decisions regarding their healthcare and clear up the confusion of Medicare.  At Senior Healthcare Team, we aren’t partial to any one insurance company.  Our loyalty is to our clients and our mission is to provide them with the best healthcare options at the very lowest cost.