Network Health 2024 Medicare Advantage PPO plans are rated 5 out of 5 stars by Medicare. Learn more.

Network Health Blog

Difference Between Medicare Advantage vs Medicare Supplement

medicare advantage vs medicare supplement side-by-side

You might think that by the age of 65 you would have learned all there is to know about navigating life, but then comes Medicare. Just as you were beginning to understand and feel comfortable with your health insurance, Medicare changes the game once you reach that milestone age, and there can be a lot to learn.

Signing up for Medicare Parts A and B (coverage for hospital visits and doctor visits, respectively) isn’t enough for many people, as Medicare in its most basic form won’t cover everything. A Medicare Advantage plan (also known as Medicare Part C) or Medicare Supplement plan (also known as Medigap), can offer you help where original Medicare falls short. Which is the best option for you? Let us help you decide by explaining the differences.

What Is a Medicare Advantage Plan? – A Brief Description

A Medicare Advantage plan offers benefits beyond what is offered by Medicare Parts A and B. In many ways, it operates similarly to the health insurance you’ve become accustomed to throughout your life.

Medicare Advantage plans start at $0 per month and offer dental, vision and hearing benefits. Most plans even offer a fitness benefit. You can also choose a Medicare Advantage plan that include pharmacy benefits not offered through original Medicare.

Is Medicare Advantage a Supplement Plan?

One helpful way to think of Medicare Advantage is that it’s a way to group Medicare Parts A, B, C and D into one comprehensive and convenient plan. It encompasses hospital visits, doctor visits, drug coverage and additional benefits that aren’t available through Original Medicare coverage.

Because of this, a Medicare Advantage plan is not the same as a supplement. While a Medicare Advantage plan is meant to offer you more than Original Medicare alone can, a supplement is designed to simply help with the costs not covered by Medicare Parts A and B.

What Is a Medicare Supplement? – A Brief Description

As we mentioned, Original Medicare often isn’t enough for many individuals, as Medicare Parts A and B don’t cover everything. A Medicare Advantage plan solves this problem by offering expanded benefits, while a Medicare Supplement seeks to solve this by helping you cover those expenses that weren’t included in the benefits from Parts A and B.

Medicare Supplement plans are frequently referred to as Medigap because they bridge the gap between what Original Medicare pays for and what you have to pay for out-of-pocket. The exact coverage will vary by plan, but for a monthly premium, you can expect coverage for deductibles, copayments and coinsurance. Medicare Supplement plans do not include drug coverage, though the benefit can often be purchased as an additional benefit through the same company.

Pros and Cons Between Medicare Advantage and Supplement

As you can see, there are some key differences between Medicare Advantage and Medicare Supplement plans. Of course, there are pros and cons to anything, so let’s compare those advantages side-by-side.

 

Benefit

Original Medicare

Medicare Supplement*

Medicare Advantage

Monthly premium

Part A is usually $0
Part B $174.70**
You must continue to pay these premiums if you’re on Original Medicare, a Medicare Supplement or a Medicare Advantage plan

Ranges from $46-$646 per month, based on age, gender and location***

As low as $0

Deductible (medical)

Part A $1,632**
Part B $240**

Ranges from
$0 - $1,632 (Part A) and
$0 - $240 (Part B)

(high deductible plan available with a $2,700 total plan deductible)

As low as $0

Covers hospital stays and doctor visits

Out-of-pocket limit

No limit on out-of-pocket costs

Depends on plan

Limit to protect you from high out-of-pocket costs*

Access to see any provider

PPO plans let you see any provider that accepts Medicare beneficiaries

Travel coverage within the United States

Prescription drug coverage

Not included

Not included

Included with most plans

Dental coverage

Not included

Generally not included

Vision coverage

Not included

Generally not included

Hearing aids

Not included

Generally not included

Fitness membership

Not included

Generally not included

*Benefits may vary based on plan
**Based on 2024 plan information
***Estimated based on assumptions for age range, location and other determining factors

 

Medicare Advantage vs Supplement Costs

Few things in life are free and Medicare is no different. Whether you choose Medigap or Medicare Advantage, you will still incur some costs for your health care needs.

With Medigap, those costs come in the form of a higher monthly premium. In exchange for paying a monthly premium, your Medicare Supplement plan helps you pay for the copayment and deductible costs that come from receiving health care.

As we’ve already discussed, Medicare Advantage plans offer expanded benefits with a low monthly premium or, in some cases, no monthly premium at all.

Does Medigap Cover Dental, Eye Exams or Hearing Aids?

As you can see from the table above, Medigap plans generally don’t include coverage for dental, eye exams or hearing aids. As with pharmacy benefits, you may be able to enroll in an add-on plan with the same company to receive such benefits, but it will be at an extra cost to your Medicare Supplement plan.

On the other hand, you will find coverage for dental, vision and hearing aids through a Medicare Advantage plan. Exact benefits will vary by plan, of course, but they will be baked into the Medicare Advantage plan you already have without the need to purchase additional coverage.

Is Medicare Advantage or Medicare Supplement Your Best Option in Wisconsin?

Only you can choose what Medicare options work best for you, whether it be the benefits of a Medicare Advantage plan, Medigap or simply Original Medicare. At Network Health, we find that many people have found a Medicare Advantage plan to be their best option here in Wisconsin, but the choice is yours.


Before you decide, consider discussing your medical needs with your personal doctor, as well as benefit details with your insurance agent. You can also call the Network Health folks here at 800-983-7587 (TTY 800-947-3529).

Y0108_4387-03-1023_C


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.

COVID-19 Information for Network Health Members