Medicare choices can feel overwhelming—especially when you’re deciding between a Medicare Supplement (Medigap) plan and a Medicare Advantage plan. This guide breaks down the differences so you can see how each option affects your coverage, costs, and access to care. We’ll walk through key features, typical expenses, and enrollment rules to help you make a confident, practical choice that fits your health and budget.

What Are Medicare Supplement Plans and How Do They Work?

Medicare Supplement plans (commonly called Medigap) work alongside Original Medicare (Part A and Part B) to help cover many of the out-of-pocket costs you’d otherwise pay yourself. Medigap can reduce or eliminate copays, coinsurance, and some deductibles—giving you more predictable medical bills when you visit the doctor or go to the hospital.

What Coverage Does Medigap Provide Beyond Original Medicare?

Medigap plans add protections that Original Medicare doesn’t include. Common benefits include:

• Deductible Coverage: Certain Medigap plans can pay the Part A deductible. Note that no Medigap plan covers the Part B deductible for people who became eligible for Medicare on or after January 1, 2020.
• Coinsurance Payments: Many plans pick up coinsurance for hospital stays and outpatient care, which can otherwise add up quickly.
• Foreign Travel Emergency: Some Medigap policies include emergency coverage for care received while traveling outside the U.S.—a benefit Original Medicare doesn’t offer.

If you see doctors often or travel, these coverages can make a big difference in your out-of-pocket spending.

Which Medigap Plans Are Available and What Are Their Key Benefits?

States offer standardized Medigap plans that vary by letter. The commonly chosen options include:

• Plan G: Broad protection—covers almost everything except the Part B deductible.
• Plan N: Lower premiums but some cost-sharing for certain office and ER visits.
• Plan F: Very comprehensive, but only available to people who were already eligible for Medicare before January 1, 2020; it covers the Part B deductible for those eligible.

Each plan balances monthly premiums with how much you’ll pay when you get care—so pick the one that fits your health needs and budget.

What Defines Medicare Advantage Plans and Their Unique Features?

Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers. These plans must cover everything Original Medicare does, but many add extras like vision, dental, hearing, and wellness programs—features you won’t usually get with Part A and Part B alone.

How Do Medicare Advantage Plans Bundle Benefits Including Part D?

Medicare Advantage plans often bundle multiple benefits into one plan, which can simplify your coverage:

• Part A and Part B Coverage: All Advantage plans include hospital and medical coverage equivalent to Original Medicare.
• Part D Prescription Drug Coverage: Most Advantage plans include prescription drug coverage, so your medications and medical care are managed within the same plan.
• Additional Services: Routine vision, dental, or hearing care and other extras are commonly included—depending on the plan.

Bundling can make it easier to manage benefits and sometimes lower your total monthly cost.

What Are the Network Restrictions and Extra Benefits of Medicare Advantage?

Medicare Advantage often uses provider networks, so how you access care depends on the plan type:

• Types of Networks: Plans can be HMOs, PPOs, or PFFS, each with different rules about seeing specialists or out-of-network providers.
• Extra Benefits: Many plans add perks like gym memberships, transportation to appointments, or wellness classes—benefits that can add real value if you’ll use them.

Know the plan’s network rules and extras before you enroll so your doctors and preferred services are covered.

How Do Medicare Supplement and Medicare Advantage Plans Compare on Costs and Coverage?

Comparing Medigap and Medicare Advantage means weighing monthly premiums against expected out-of-pocket costs and the flexibility to see providers you trust. Below are the typical differences to consider.

What Are the Differences in Premiums, Deductibles, and Out-of-Pocket Limits?

The table below summarizes common cost differences between the two plan types:

Plan Type	Premiums	Deductibles	Out-of-Pocket Limits
Medicare Supplement	Generally higher monthly premiums	Varies by plan	Original Medicare has no yearly limit, but Medigap covers most extra costs
Medicare Advantage	Often lower monthly premiums	Varies by plan	Has an annual out-of-pocket maximum (set by CMS and varies by plan)

In short: Medigap tends to trade higher premiums for predictable, minimal medical bills; Advantage plans usually have lower premiums but include annual limits on how much you’ll pay out of pocket.

How Does Prescription Drug Coverage Differ Between Medigap and Medicare Advantage?

Prescription coverage is an important difference. Most Medicare Advantage plans include Part D drug coverage. Medigap policies do not include drug coverage, so if you choose Medigap you’ll need a separate Part D plan to cover prescriptions. Factor that extra cost into your comparison.

Who Should Choose Medicare Supplement vs Medicare Advantage: Personalized Decision Factors

Your best choice depends on your health, how often you see doctors, and what you can afford each month. Here are common situations to help guide you.

Which Plan Is Best for Healthy Seniors, Chronic Conditions, or Budget-Conscious Individuals?

1. Healthy Seniors: Medicare Advantage can be a good fit because of lower premiums and extra benefits.
2. Individuals with Chronic Conditions: Medigap often makes more sense if you expect frequent doctor visits or hospital stays—because it reduces unpredictable costs.
3. Budget-Conscious Individuals: Those focused on low monthly costs may prefer Medicare Advantage, but be mindful of service rules and copays.

Think about how often you use care, whether you travel, and whether you want the freedom to see any provider who accepts Medicare.

How Does Provider Choice and Lifestyle Influence Plan Selection?

Your preferred doctors and daily life matter. We help clients weigh provider access, travel plans, and long-term financial goals so the plan fits not just today’s needs, but tomorrow’s too. A quick conversation lets us compare carriers and tailor options to your lifestyle—whether planning for retirement, travel, or ongoing care.

What Are the Enrollment Periods and Rules for Switching Between Medicare Plans?

Knowing when you can enroll or change plans protects you from coverage gaps and unexpected underwriting. Here are the main enrollment windows to remember.

When Can You Enroll or Switch Plans Without Medical Underwriting?

Common enrollment periods include:

• Initial Enrollment Period: The seven-month window around the time you first become eligible for Medicare.
• Annual Election Period (Open Enrollment): October 15 – December 7 each year to join, drop, or switch plans without medical underwriting.
• Medicare Advantage Open Enrollment Period: January 1 – March 31 for people already in an Advantage plan to change plans or return to Original Medicare (note: returning to Original Medicare doesn’t automatically guarantee Medigap coverage).
• Special Enrollment Periods: Life events—like moving or losing other coverage—can trigger a Special Enrollment Period to change plans outside the standard windows.

What Are the Implications of Switching from Medicare Advantage to Medigap?

Going from Medicare Advantage back to Medigap can be tricky. Outside your Medigap Open Enrollment Period (which starts the month you turn 65 and have Part B), insurers can require medical underwriting. That means they can charge higher premiums or deny coverage based on your health. Know your enrollment timing before you switch to avoid surprises.

How Can Mauldin Insurance Group Help You Navigate Medicare Supplement and Advantage Choices?

We specialize in making Medicare simple and personal. Our team listens to your concerns, explains options in plain language, and helps you compare plans so you can choose with confidence—not confusion.

What Personalized Services and Expertise Does Mauldin Insurance Group Offer?

We start with a short conversation to learn your goals, family situation, and budget. From there we:

• Explain plan differences in everyday terms
• Compare rates from leading carriers
• Customize quotes to fit your needs—without high-pressure sales

Our focus is clear guidance so you can make the right decision for your health and finances.

How to Schedule a Free Medicare Review for Tailored Plan Recommendations?

To schedule a free Medicare review, call us at (843) 509-2462 or (803) 920-8827. You can also text (803) 848-9461, email us for assistance, or visit our website and complete the contact form. We’ll set up a no-cost, no-pressure consultation to review your options.

 

Frequently Asked Questions

What are the eligibility requirements for Medicare Supplement and Medicare Advantage plans?

Medigap: You must be enrolled in Original Medicare (Part A and Part B) and, in most cases, be 65 or older—though some states allow younger people with disabilities to buy Medigap. Medicare Advantage: You must have Medicare Part A and Part B and live in the plan’s service area. Most Advantage plans don’t accept enrollees with end-stage renal disease (ESRD), though there are exceptions.

Can I have both a Medicare Supplement plan and a Medicare Advantage plan?

No. You can’t have Medigap and a Medicare Advantage plan at the same time. If you enroll in an Advantage plan, it replaces Original Medicare and Medigap won’t apply. To switch from Advantage to Medigap, you generally must leave the Advantage plan first and be aware of any underwriting rules.

How do I choose between a Medicare Supplement and a Medicare Advantage plan?

Base the decision on your health care habits, preferred doctors, and budget. If you want flexibility and predictability in costs, Medigap may be better. If you want lower premiums and extra benefits in one bundled plan, Medicare Advantage could be the right fit. We can compare real plan options for your situation.

What happens if I miss the enrollment period for Medicare plans?

If you miss your Initial Enrollment Period or the Annual Election Period, you may have to wait until the next window to enroll. You might qualify for a Special Enrollment Period for certain life events, like moving or losing other coverage. Delays can lead to gaps in coverage or late-enrollment penalties, so checking your timing is important.

Are there any out-of-pocket costs associated with Medicare Supplement plans?

Yes. While Medigap pays many of the costs Original Medicare doesn’t, you’ll still pay the Medigap premium. Some Medigap plans may also have small deductibles or cost-sharing—so review each plan’s details to know what you’ll owe beyond the monthly premium.

How do I find the right Medicare plan for my specific needs?

Start by listing your medical needs, how often you visit doctors, and whether you travel. Then compare costs, provider networks, and benefits. You can use online tools, talk with a licensed agent, or contact Mauldin Insurance Group for a personalized review tailored to your situation.

 

Conclusion

Choosing between Medicare Supplement and Medicare Advantage affects both your care and your wallet. Each option has clear strengths—Medigap for predictable costs and broad provider access, Advantage for lower premiums and extra benefits. If you’re unsure which path fits you best, contact Mauldin Insurance Group for a complimentary review. We’ll help you find the plan that matches your health needs and financial goals.