Comparing Medigap and Medicare Advantage
Updated: May 22, 2019
What are the costs of Medigap and Medicare Advantage premiums?
First, let's look at the approximate premiums you might expect to pay with either plan. On average, you might pay between $100 and $150/month for your Medigap premium (factors such as which Medigap plan you choose, your age, and your location have a major impact). You'll likely pay less for your Medicare Advantage premium - usually not more than $50/month, but sometimes there won't be any extra premium (keep in mind, you still need to pay your Medicare Part B premium).
What are the out-of-pocket costs for Medigap and Medicare Advantage?
With a Medigap plan, your out-of-pocket costs for visiting the doctor are usually very limited. In the case of Plan F, you'll have zero out-of-pocket costs. With Medicare Advantage, deductibles and co-pays can add up to usually between $3,400 and $6,700 a year before being capped by your specific plan (each plan has its own defined out-of-pocket maximum).
What are the enrollment periods for Medigap and Medicare Advantage?
The initial open enrollment period for Medigap is the first six months after you sign up for Part B and are at least 65 years old. That said, you can enroll in a Medigap plan at any time once you're eligible, you'll just need to go through underwriting if you missed your initial enrollment window. For Medicare Advantage, the open enrollment period is when you first enroll in both Medicare A and B and annually thereafter between October 15 and December 7.
Can you choose your doctor/hospital with Medigap and Medicare Advantage?
With Medigap, you can go to any doctor or hospital that accepts Medicare. A Medicare Advantage plan, on the other hand, is a network plan (for example, an HMO or PPO). You'll want to make sure your primary care physician accepts your specific Medicare Advantage plan and you'll likely need a referral to see a specialist.