Learn about the differences between Medicare Advantage and Medicare Supplement plans and compare coverage to decide which plan is best for you.


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Medicare Advantage vs. Medicare Supplement

Medicare Advantage vs. Medicare Supplement (Medigap) | Humana

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Coverage for those 65+ or eligible due to certain health conditions.

Stand-alone plans for dental, vision and hearing care.

Coverage for adults and children who qualify based on income.

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Learn about Original Medicare vs. Medicare Advantage

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Medicare Advantage vs. Medicare Supplement Insurance (Medigap): What’s the difference?

Medicare Advantage (Part C) and Medicare Supplement plans help pay for costs not covered by Original Medicare (Parts A and B). However, they provide 2 different types of coverage, but they don’t work together.

Let’s compare both types of Medicare plans to see which 1 may best fit your needs.

Medicare Advantage bundles Original Medicare Parts A and B into 1 plan and usually includes Medicare Part D prescription drug coverage. Some Medicare Advantage plans may also offer extra benefits, such as routine dental, vision and hearing services. 

A Medicare Supplement plan, also called Medigap, is secondary insurance—it’s extra coverage you can buy to complement your Medicare Part A and Part B coverage. It helps pay out-of-pocket expenses Original Medicare doesn’t pay, like deductibles and copays.

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Includes Original Medicare Parts A and B, plus extra benefits, such routine dental, vision, hearing and fitness services

Helps fill the “gaps” in Original Medicare, covering the out-of-pocket costs Parts A and B don’t

There are specific enrollment periods during the year when you can enroll in or switch to a different Medicare Advantage plan

You can apply for a Medigap plan at any time throughout the year. Your application may be subject to underwriting.

You may be required to use in-network doctors and hospitals

You can see any doctor that accepts Medicare patients

Premiums vary by company, location and plan choice, but many plans feature $0 monthly premiums&nbsp;

Premiums vary by company, location and plan choice

Often included in a Medicare Advantage Prescription drug plan (MAPD)

Medicare Supplement insurance plans do not provide prescription drug coverage

All health conditions accepted, including ESRD

Not required if applying during your 6-month Medigap Open Enrollment Period or if you qualify for a guaranteed issue right&nbsp;

For a deeper understanding, let’s explore the details of each plan.

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 help pay 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:

65 years old or older

Enrolled in Medicare Parts A and B

Living in the state where the policy you want is offered

Note: In some states, you may be eligible if you’re 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 is likely to cost.

Medicare Advantage is an alternative to Original Medicare. It’s offered by private insurance companies. 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, ({part_b_premium} in {year}) 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.

How to switch from a Medicare Supplement plan to a Medicare Advantage plan

To switch from Medigap to Medicare Advantage, you’ll have to wait for the Medicare Open Enrollment Period, which runs Oct. 15 to Dec. 7 each year. 

How to switch from a Medicare Advantage plan to a Medicare Supplement plan 

A Medicare Supplement insurance plan can only be used to help pay out-of-pocket costs not paid by Original Medicare. If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to see when you’re able to disenroll.

Once you’re enrolled in Original Medicare, you can apply for a Medigap plan but you may be subject to medical underwriting. 

Note: In some cases, when you switch from Medicare Advantage to Original Medicare, you may have “guaranteed-issue” rights to buy a Medicare plan. Without these special rights, insurance companies may choose to review your medical history before selling you a plan. 

] Medicare Advantage and Medicare Supplement plans each offer ways to potentially save you money and help you get more out of your healthcare. Try these tips for choosing the right Medicare coverage for you.

Plan features	Medicare Advantage	Medicare Supplement
Coverage	Includes Original Medicare Parts A and B, plus extra benefits, such routine dental, vision, hearing and fitness services	Helps fill the “gaps” in Original Medicare, covering the out-of-pocket costs Parts A and B don’t
Enrollment	There are specific enrollment periods during the year when you can enroll in or switch to a different Medicare Advantage plan	You can apply for a Medigap plan at any time throughout the year. Your application may be subject to underwriting.
Doctors and hospitals	You may be required to use in-network doctors and hospitals	You can see any doctor that accepts Medicare patients
Referrals	May need referrals for specialists	No referrals necessary
Costs	Premiums vary by company, location and plan choice, but many plans feature $0 monthly premiums	Premiums vary by company, location and plan choice
Prescription drug coverage	Often included in a Medicare Advantage Prescription drug plan (MAPD)	Medicare Supplement insurance plans do not provide prescription drug coverage
Medical underwriting	All health conditions accepted, including ESRD	Not required if applying during your 6-month Medigap Open Enrollment Period or if you qualify for a guaranteed issue right

Comparing Medicare Advantage vs. Medigap