How Is Medicare Advantage Different from Medicare Supplement?

Medicare Advantage and Medicare Supplement (or MediGap) plans haven’t always been available. Originally, Medicare only had two elements: Medicare Part A, or hospital insurance, which covered hospital visits and some other medical facility expenses; and Medicare Part B, which provided coverage for doctor visits and other specific healthcare costs. Together these elements are often referred to as ‘traditional Medicare.’

Observing the gaps in coverage that evolved due to advances in medical science, the government started building additional plan options for seniors who wanted to be prepared for these additional expenses. So what are the differences between Medicare Advantage and MediGap plans? Let’s take look at them.

What is a Medicare Advantage plan?

Medicare Advantage (or Medicare Part C) was created in the late ’90s to help provide personalized care options for seniors and potentially help them save money in the face of rapidly rising medical costs. To accomplish this, the government turned to private companies for the development of plans that would meet certain criteria established by Medicare. Essentially, these criteria sought to protect seniors from companies using deceptive business practices. Before any Medicare Advantage plan can be marketed, it must receive approval from Medicare.

What does Medicare Advantage cover?

All Medicare Advantage plans must provide the services covered by traditional Medicare (Medicare Part A and Medicare Part B). They may, however, offer a number of additional benefits. Some of these plan benefits may include:

  • Dental care coverage
  • Eye care coverage
  • Hearing care coverage
  • Worldwide urgent care and emergency coverage
  • Mail-order pharmacy program
  • Wellness and fitness programs
  • 24/7 nurse line

What is a Medicare Supplement Insurance plan?

Medicare Supplement Insurance plans (MediGap plans) have very specific features designed to assist different groups of seniors, based on their needs. You may want to look into these plans if you’re a senior who:

  • can meet many of your healthcare requirements through traditional Medicare.
  • has a number of medical needs above and beyond what traditional Medicare covers.
  • is looking to control medical costs.

What do MediGap Plans pay for?

Medicare set up MediGap plans with specific sets of defined features. These plans may offer help with some or all of the items below:

  • Medicare Part A Deductibles
  • Medicare Part B Deductibles
  • Coinsurance and excess charges from your care provider
  • Blood transfusion expenses
  • Hospital stay costs above and beyond what Medicare Part A covers
  • Coinsurance for hospital and skilled nursing facility stays
  • Preventive care benefits
  • Foreign emergency medical benefits
  • A certain amount of prescription drugs your care provider gives you