Once you have Original Medicare (Parts A and B), you reach a fork in the road, and it’s one of the biggest choices you’ll make: add a Medigap policy, or switch to a Medicare Advantage plan. Neither is “better” — they’re just different. Here’s how I explain them.
Medigap (also called a Medicare Supplement) works *alongside* Original Medicare. It picks up your share of the bills — the deductibles and the 20% coinsurance — so your costs are predictable. You can see any doctor in the country who accepts Medicare, with no networks and no referrals. The trade-offs: a monthly premium, and it doesn’t include drug coverage, so you add a separate Part D plan. Medigap suits people who want freedom to choose doctors and few surprises at the counter.
Medicare Advantage (Part C) *replaces* Original Medicare with a private all-in-one plan. Many have a low or $0 monthly premium and throw in extras like dental, vision, or hearing. The trade-offs: you use the plan’s network of doctors, you may need referrals and prior approvals, and you pay copays as you go, up to a yearly limit. Advantage suits people who want low upfront cost and extra benefits and are comfortable staying in a network.
One thing I always tell people: choose carefully at the start. When you first get Medicare, you can buy any Medigap policy without a health review. If you start with Advantage and want to switch to Medigap later, insurers can look at your health and charge more — or say no. So it’s easier to start with Medigap and switch to Advantage than the other way around.
Ada’s Bottom Line
1. Medigap works with Original Medicare (any doctor, predictable costs, a premium, add Part D). Advantage replaces it (networks, extras, low premium, pay-as-you-go).
2. Neither is “best” — it depends on your health, your doctors, your medications, and your budget.
3. Choose carefully at first: switching from Advantage back to Medigap later can require a health review and cost more.
The right choice really is personal. To see what you personally qualify for — with your own numbers and state — use GoldieCircle’s free Benefits Checker (the “Find Benefits” option in Ask Goldie). For free, one-on-one help, your local SHIP counselor is wonderful (Source: Medicare.gov).
Ada spent more than 30 years as a SHIP benefits counselor helping seniors and families understand Medicare, Medicaid, and the programs that help pay for them. Confused by a letter, a form, or a bill? Ask Ada.
💡 Have a question for Ada? Use “Questions from readers” just above — Ada answers within the hour. Comments here are for sharing with other members (but Ada reads them too).
Loading comments…