Medicare Advantage vs. Medicare Supplement (Medigap) (2024)

Medicare Supplement plans, also known as “Medigap,” help pay your share of medical costs not paid by Original Medicare, like copayments, coinsurance and deductibles. Some Medigap plans may also assist in paying for home healthcare, durable medical equipment (DME), hospital costs and lab costs.

Who is eligible for Medicare Supplement insurance?

You’re eligible to buy a Medicare Supplement plan if you’re:

1. 65 years old or older
2. Enrolled in Medicare Parts A and B
3. Living in the state where the policy you want is offered

Note: In some states, you can be under age 65 with a disability or end-stage renal disease (ESRD).

How much does Medicare Supplement insurance cost?

The Medicare Supplement premium you pay can depend on your plan, your age and where you live. Generally, the more coverage you choose, the more your plan can cost. Some Medicare Supplement plansset a maximum out-of-pocket limit.

Medicare Advantage is an alternative to Original Medicare, and it is offered by private insurance companies to Medicare beneficiaries. Medicare Advantage plans include Part A and Part B coverage, and some include Part D prescription drug coverage as well. Some Medicare Advantage plans also offer extra benefits that aren’t available with Original Medicare, such as routine vision, hearing and dental care.

Who is eligible for Medicare Advantage?

To join a Medicare Advantage Plan, you must:

• Be enrolled in Medicare Parts A and B
• Live in the plan’s service area
• Be a U.S. citizen or lawfully present in the U.S.

Note: You may also be eligible if you’re under 65 and have Medicare because of a disability.

How much does Medicare Advantage cost?

Medicare Advantage premiums, deductibles and other costs can vary by plan and change each year. You must pay the Part B premium ($174.70 in 2024) and keep paying it to stay in your plan. The out-of-pocket limit can also vary by plan, but once you reach it, the plan pays 100% of your covered health services for the rest of the year.

Switching from a Medicare Supplement plan to a Medicare Advantage plan

Medicare Supplement plans help cover some costs that Original Medicare doesn’t pay, but they don’t include routine dental, vision, hearing or prescription drug benefits. If you’re interested in those extra benefits, learn about switching to an all-in-1 Medicare Advantage prescription drug plan.

However, you can’t switch from Medigap to Medicare Advantage at any time. You’ll have to wait for the Medicare Open Enrollment Period, which runs from Oct. 15 to Dec. 7 each year. Be sure to contact your Medigap insurance company to tell them you’re cancelling before you enroll in a Medicare Advantage plan.

Switching from a Medicare Advantage plan to a Medicare Supplement plan

If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to see if you're able to disenroll. If you’re able to disenroll and return to Original Medicare, you can only leave a Medicare Advantage plan during 2 enrollment periods:

1. The Medicare Advantage Open Enrollment Period (MA OEP) between Jan. 1 and March 31.
2. The Annual Enrollment Period (AEP) between Oct. 15 and Dec. 7.

Once you’re enrolled in Original Medicare, you’re generally eligible to apply for a Medigap plan.

Note: In most cases, when you switch from Medicare Advantage to Original Medicare, you lose your “guaranteed-issue” rights for Medigap. You generally have guaranteed-issue rights for 6 months when you’re 65 or older and enrolled in Medicare Part B. Without guaranteed-issue rights, insurance companies may require medical underwriting before selling you a plan.