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A Comparison Between Medicare Advantage and Medigap

If you’re ready to sign up for Medicare, you have another important decision to make: should you choose Medicare Advantage or Medigap to supplement your Medicare?

Your choice depends on factors like your lifestyle, health condition, and finances. Here are all the things you should consider.

Costs: Medicare Advantage plans can save you money, but you should check whether prescription drug benefits are included. Otherwise, you’ll have to buy Part D separately to cover prescription drugs. Remember to check premium, copays, and other out-of-pocket expenses and if there are any coverage limits too. Check if hearing aids and dental bills are covered and to what extent. Compare these costs to Medigap costs and stand-alone Medicare Part D costs.

Doctor of choice: Original Medicare lets you choose any U.S. doctor or hospital that accepts Medicare. Medicare Advantage restricts you to using physicians in their network and could cover less or none of the expenses of using any out-of-network and out-of-town providers.

Local conditions and convenience: You should always check the network of available Medicare Advantage plans and the locations of providers that accept Medicare. Check if the doctors are accepting new patients too. Know how far you have to travel to see a provider or be treated in an emergency room. Speak to local professionals, neighbors, and licensed insurance brokers to help you find the right plan that works in your area.

Lifestyle: Regular Medicare may be a good choice if you travel frequently, have dual residences, and have physicians that you would like to retain. Ask your current doctor if they participate in Medicare Advantage or accept regular Medicare. Frequent fliers can choose regular Medicare with Medigap that covers emergency care in foreign countries. The same applies to people that spend a good part of the year in different countries and won’t be able to stay in-network for medical care.

Health: If you have chronic diseases and have serious health conditions, then a Medicare Advantage plan may be better, especially if it has an out-of-pocket maximum that protects you from large bills. If you want more choice in where you receive care, then regular Medicare plus Medigap works better. Check whether expensive equipment or drugs are covered.