How are medigap and medicare advantage plans different?

HOW AND WHEN SHOULD I SHOP FOR A MEDIGAP POLICY? You can buy a Medigap policy any time you have Medicare Part A and Part B. But Medigap insurers in most states can reject you or charge more 

if you have preexisting conditions unless you buy a policy during certain times, such as within six months of enrolling in Medicare Part B if you’re 65 or older. Medigap insurers must also

offer you a policy regardless of preexisting conditions in other situations, such as if you were enrolled in a Medicare Advantage plan but moved outside of the plan’s service area. Some

states have extra protections. Contact your State Health Insurance Assistance Program (SHIP) to find out more about your state’s rules. When exploring your options, you can find out more

about Medigap plans in your area from the Medicare Plan Finder or from your state insurance department. HOW DOES MEDICARE ADVANTAGE DIFFER FROM MEDIGAP? Medicare Advantage, also known as

Medicare Part C, is an all-in-one alternative to original Medicare. Medicare Advantage plans are offered by private companies that contract with Medicare. These plans bundle Part A hospital

coverage, Part B doctor and outpatient services, and usually Part D prescription drug coverage into one package. If you decide to get coverage through a Medicare Advantage plan, you’ll still

have to enroll in Medicare Part A and Part B, including paying the premiums. Part A is premium-free for most people, but Part B costs $174.70 a month in 2024. High earners pay more. You may

have to pay additional monthly premiums to the Medicare Advantage plan, which average $18.50 in 2024, but two-thirds of Medicare Advantage enrollees pay no separate premium. WHAT MEDICARE

ADVANTAGE COVERS. The federal government requires Medicare Advantage plans to cover everything that Medicare Part A and Part B cover, but they may have different deductibles and copayments.

Most Medicare Advantage plans include prescription drugs, too, and many help pay for services original Medicare doesn’t cover, such as routine dental, hearing and vision care. PROVIDER

NETWORKS. Unlike original Medicare and Medigap, which cover all doctors and other providers who accept Medicare, most Medicare Advantage plans have a provider network and may charge more or

may not cover doctors or facilities outside of a plan’s network. OUT-OF-POCKET MAXIMUMS. All Medicare Advantage plans have federal rules that limit annual out-of-pocket costs for services

covered under Medicare Part A and Part B. In 2024, this is $8,850 or less for in-network health services, and $13,300 or less for covered in-network and out-of-network services combined.