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While Original Medicare (Part A and Part B) covers many healthcare services, it does not cover everything. Beneficiaries are still responsible for deductibles, copayments, and coinsurance, which can add up over time.
Many people choose additional coverage through either a Medicare Supplement (Medigap) plan or a Medicare Advantage plan.
Understanding the differences between these options can help you choose the plan that best fits your healthcare needs and budget.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans work alongside Original Medicare (Part A and Part B). Medicare remains your primary insurance, paying its share of approved healthcare costs first, while your Medigap plan helps cover many of the remaining out-of-pocket expenses.
Medicare Supplement plans may help cover:
- Copayments
- Coinsurance
- Deductibles
One of the key advantages of Medicare Supplement plans is the freedom and flexibility they offer. You can visit any doctor, specialist, or hospital in the United States that accepts Medicare, without provider networks or referrals. In most cases, preauthorization is not required for services, making care easier to access.
Medicare Advantage Plans (Part C)
Medicare Advantage plans are offered by private insurance companies and provide an alternative way to receive your Medicare benefits.
These plans combine your Part A and Part B coverage into one plan and often include prescription drug coverage and additional benefits, such as dental and vision.
Many Medicare Advantage plans have lower monthly premiums, but they typically operate within provider networks, such as HMO or PPO plans. This means you may need to use doctors and hospitals within the plan’s network, and some services may require preauthorization.
Medicare Advantage plans can change benefits, costs, and networks, and may discontinue plans each year. Doctors can leave the network at any time.
Medicare Supplement vs. Medicare Advantage
| Medicare Supplement | Medicare Advantage |
| Any doctor that accepts Medicare nationwide | Limited to plan networks |
| Referrals not required | Referrals required |
| No network restrictions | HMO or PPO networks |
| Minimal out-of-pocket cost | Annual maximum out-of-pocket limit usually up to $10,000/year |
| Nationwide coverage | Usually local or regional networks |
| Requires separate Part D plan | Part D plan included |
Medicare Guidance You Can Trust
With clarity, care, and experience, we’re here to help you navigate your options and make confident decisions—so you can move forward with peace of mind.
