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Pros and Cons of Medicare Advantage and Medigap Plans

pros and cons of medicare advantage and medigap plans
Pros And Cons of Medicare Advantage And Medigap Plans

We will review the Pros and Cons of Medicare Advantage and Medigap Plans to guide you on how to make well-informed choices.


Medicare Advantage Plans Pros


Coordinated and convenient medical care

Though there are Pros and Cons of Medicare Advantage and Medigap Plans, but sometimes it’s easier to get everything you need in one place. Hence, Medicare Advantage Plans is all about getting the most out of one plan through organization. They are also known as Medicare private health plans or Part C. These types of plans are offered by a private insurance company and includes coverage for everything that the original Medicare covers.


Wider coverage

Medicare Advantage Plans cover more. For instance, many Part C companies offer prescription drug coverage as well as dental, ocular, and hearing benefits. Some also include coverage for subscriptions like fitness memberships, others even connect you to wellness coaches on your smart device to enable you attain your health goals.

With a Medicare Advantage Plan, you will pay a monthly Part B premium to Medicare in addition to any premiums you pay to the insurer – the company that facilitates your plan. There are Pros and Cons of Medicare Advantage and Medigap Plans but advantages are more.



Medicare Advantage Plans can offer great benefits at a reasonable price. Research on the Pros and Cons of Medicare Advantage and Medigap Plans has shown that you can save money on laboratory services and medical equipment by securing a Medicare advantage policy.

Some advantage plans do not have any costs for certain premiums or deductibles. Another advantage of Medicare advantage is that there is an annual out-of-pocket amount.




Limited service providers

If you select popular Medicare advantage plan types such an HMO plan, you may have limited providers. You may even be charged higher fees if you choose an out-of-network provider when you opt for these plans.


Overwhelming plan offerings

The drawback to having options is that they can be overwhelming, especially when evaluating and selecting health policies.


State-specific coverage

Original Medicare offers coverage all over the US. However, most Medicare Advantage plans offer coverage specific to your service region. Hence, if you travel frequently, your advantage plan may not cover your out-of-state services.


Medigap Plans


Pros and Cons of Medigap Plans

Medigap, also known as Medicare Supplement Plans, is a private insurance policy that covers the deficiencies of Medicare. It’s an insurance amplifier that provides supplemental health insurance coverage for the beneficiaries of Medicare. The big question is: why should anyone who already have Medicare seek out a Medigap policy?

The aim of the Medigap plan is to refund you for all the expenditure made out of your pocket for Medicare Part A and Part B.  These programs are provided by private insurance companies.


The cost of multiple medical needs may hurt your finances

Experts who review Pros and Cons of Medicare Advantage and Medigap Plans say that considering basic Medicare without supplementary insurance could be a costly mistake. In a 2018 study, about 19% or 6.1 million had only basic Medicare with no additional coverage. Whereas Part A is free for many beneficiaries, it comes with a $1,632 deductible in 2023.  While Part B comes with a low $240 deductible in 2024, you typically pay 20% of the remaining costs, usually doctor services – including while you’re receiving inpatient care at the hospital, or as an outpatient.

With the 20% deductible in mind, remember that there is no limit to the amount that you can pay out of pocket. For example, if you suffer a cardiac arrest, require multiple surgeries, and hospital visitations, you could wind up bankrupt, literally.

Heart bypass surgery commands over $100,000, according to Statista, while heart-valve replacement can cost an excess of $170,000. Now if all those charges where run through Part B, your 20% share should be at around $20,000 for the heart bypass and $34,000 for valve replacement.


It reduces hassles down the line

When you first enlist in Medicare Part B, you are allowed six months to buy a Medigap plan without an insurance facility prying into your health history to decide whether to give you cover. After that window, you would have to undergo medical history queries.


Cons of Medigap plans

Drug Coverage: Medigap policies do not help cover prescription drugs

Expensive Premiums: For some individuals, paying a Medicare Supplement may be too costly

Eligibility: most states require individuals to be 65 or older and all states require prospective beneficiaries to have Part A and Part B.

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