Insurance Curator Making the right Medicare choice at 65+ can affect your health, finances, and peace of mind for years. This article compares Medicare Supplement (Medigap) and Medicare Advantage (MA/Part C) for seniors in the United States, shows typical costs, highlights which seniors benefit most from each option, and lists major insurers and regional considerations to help you choose the best fit.
Quick TL;DR
- Medigap (Supplemental): Higher monthly premiums, predictable out-of-pocket costs, nationwide provider access (with Original Medicare), best for frequent doctors/hospital users and travelers.
- Medicare Advantage (MA): Often low or $0 monthly premium, integrated Part A/B plus usually Part D, but uses networks and cost-sharing can be higher for frequent care. Best for seniors looking to limit monthly premium and who are comfortable with restricted networks.
Sources used for rates, averages and program rules: Medicare.gov, CMS, Kaiser Family Foundation (links at bottom).
What each plan covers — plain language
Original Medicare + Medigap (Supplement)
- You keep Original Medicare (Part A hospital + Part B medical).
- Buy a Medigap policy from a private insurer to cover Part A/B deductibles, coinsurance, and other gaps (varies by Medigap plan letter: G, N, etc.).
- No provider networks — see any provider that accepts Medicare.
- Prescription drugs require a separate Part D plan.
Medicare Advantage (Part C)
- Private plans that replace Original Medicare, bundling Part A and B, and usually include Part D (drug coverage).
- Types: HMO, PPO, PFFS, SNPs — networks and rules vary.
- Typically include extra benefits (dental, vision, fitness) not covered by Original Medicare.
Cost comparison (typical national ranges)
| Cost element | Medicare Supplement (Medigap) | Medicare Advantage (MA) |
|---|---|---|
| Monthly premium | $100–$300+ (varies by plan, age, location) | $0–$50 typical; CMS average MA premium was $18 in 2024 (many $0 plans available) [CMS] |
| Out-of-pocket when care needed | Low — plan covers most deductibles/coinsurance depending on plan (e.g., Plan G) | Can be high for hospitalization or specialists depending on plan cost-sharing |
| Drug coverage | Not included — must buy Part D separately | Often included (Part D) |
| Network restrictions | None (Original Medicare) | Often network-based (restrictive for out-of-area care) |
| Best if you want | Predictability and broad provider access | Low premiums and bundled convenience |
Note: Medigap premiums vary widely by state, insurer, and rating method (community-rated, issue-age, attained-age). See Medicare.gov for plan details and local quotes.
Sources: Medicare.gov (Medigap basics), CMS MA premium report, Kaiser Family Foundation analysis.
Who should choose which — practical guidance
Choose Medigap if you:
- Travel frequently within the U.S. or spend time in multiple states (no network limits).
- See multiple specialists or visit hospitals often and want predictable costs.
- Prefer paying higher monthly premiums in exchange for low or no copays/coinsurance at point of care.
- Want Original Medicare’s provider freedom.
Choose Medicare Advantage if you:
- Want low or $0 monthly premium and integrated drug coverage.
- Are comfortable with provider networks and prior authorizations.
- Want extra benefits (dental, hearing, vision, fitness) included.
- Live in urban/suburban areas with strong MA plan choices (e.g., Phoenix, AZ; Miami, FL).
Real-world pricing examples and major insurers
Premiums change by county, age, tobacco use, and underwriting method. Below are representative examples (approximate ranges) by location for a 65-year-old enrolling during Initial Enrollment Period. Use these ranges to orient decisions; get live quotes for accuracy.
- Phoenix, AZ
- Medigap Plan G: $110–$260/month
- Medicare Advantage: Many carriers (UnitedHealthcare, Humana, Aetna) offer $0–$20/month MA plans in Maricopa County.
- Miami-Dade, FL
- Medigap Plan G: $120–$320/month
- Medicare Advantage: Humana, UnitedHealthcare, and regional Blue plans offer $0–$40/month options.
- Cuyahoga County (Cleveland), OH
- Medigap Plan G: $90–$230/month
- Medicare Advantage: Local Blue Cross plans, Aetna, and others: $0–$25/month.
Major companies and how they typically position products:
- UnitedHealthcare: Large MA market share; many $0 premium MA plans and extensive Part D options.
- Humana: Strong MA presence with $0-premium plans and extras (dental/vision).
- Aetna: MA plans with broad provider networks; offers both MA and some Medigap in select states.
- Cigna & Mutual of Omaha: Common Medigap underwriters with Plan G/N offerings.
- Blue Cross Blue Shield (independent state plans): Both Medigap and MA products—often strong provider networks locally.
For exact quotes, check insurer sites or a broker. See Medicare.gov to compare plans by ZIP code.
(Sources: insurer plan pages, local rate surveys; CMS MA premium averages and Medicare.gov Medigap information.)
Coverage trade-offs — a closer look
- Network vs. freedom: Medigap = freedom; MA = network savings but potential out-of-network penalties.
- Predictability vs. variability: Medigap gives predictable OOP costs; MA can have low premiums but higher unexpected cost-sharing.
- Drug coverage: MA often includes Part D. With Medigap, you must buy a Part D plan (extra monthly cost).
- Chronic conditions: If you need regular in-network specialist visits, a comprehensive MA plan with predictable copays could work — but frequent hospitalizations often favor Medigap.
Enrollment rules & switching
- Best time to buy Medigap: Medigap Open Enrollment (6 months starting the month you’re 65 and enrolled in Part B) — guaranteed issue rights in many states. After this, insurers may underwrite.
- MA enrollment windows: Initial Enrollment Period (IEP), Annual Election Period (Oct 15–Dec 7), and Medicare Advantage Open Enrollment (Jan 1–Mar 31) with limited switching rules.
- Switching from MA to Original Medicare + Medigap: If outside guaranteed issue, you may face medical underwriting and higher premiums.
See Medicare.gov and your state Health Insurance Assistance Program (SHIP) for specifics.
Tips to lower costs
- Compare both MA and Medigap quotes by ZIP code—costs vary widely by county.
- Consider Plan N vs Plan G tradeoffs if choosing Medigap (Plan N has lower premium, some copays).
- If on a fixed income, check Extra Help for Part D and consider programs listed in Best Insurance For Seniors on a Fixed Income: Ways to Lower Premiums Across Policy Types.
- If drugs are a priority, read Best Insurance For Seniors to Cover Prescription Drug Costs: Part D and Extra Help Programs.
- For deep Medigap comparisons and provider ratings, see Best Insurance For Seniors 65+ Comparing Top Medigap Plans and Provider Ratings.
How to decide — step-by-step
- List your providers and check if they accept MA plan networks in your county.
- Estimate yearly medical use (hospitalizations, specialist visits, prescriptions).
- Get live quotes for Medigap Plan G/Plan N and for 3–5 MA plans in your ZIP code.
- Compare total annual expected cost: (monthly premiums x12) + expected copays + deductibles.
- Factor in travel needs, provider continuity, and prescription formularies.
Bottom line
- There's no one-size-fits-all. If you value predictability and provider freedom, Medigap (with separate Part D) is usually best. If you want low monthly premiums, integrated drug coverage, and extras, Medicare Advantage may be better.
- Use local quotes and network checks to choose. Major carriers such as UnitedHealthcare, Humana, Aetna, Cigna, Mutual of Omaha, and state Blue Cross plans are key players depending on your county.
External references
- Medicare.gov — Medigap basics: https://www.medicare.gov/supplements-other-insurance/medigap
- CMS — Medicare Advantage 2024 premium information (CMS releases/press statements): https://www.cms.gov/newsroom
- Kaiser Family Foundation — Analysis of Medicare Advantage and supplemental coverage: https://www.kff.org/medicare
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