COVERAGE OPTIONS
Medicare includes various types of coverage, and the terminology can be difficult to navigate on your own. If you’re not sure which fits your needs, that’s exactly what we’re here to help with. Below is a breakdown of the three paths we’ll walk you through together. Our goal is to give you clear, accurate information so you can make the choice that’s right for you.
Medicare Supplements
(Medigap)
Medigap plans work alongside Original Medicare (Part A and Part B) to help cover costs like copayments, coinsurance, and deductibles. Medicare pays its share first, then your Medigap plan covers its portion — often leaving little to no out-of-pocket cost.
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See any doctor or hospital that accepts Medicare, nationwide — no networks or referrals
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Monthly premiums are typically higher than Medicare Advantage, but in most cases, you will pay less when you need care
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Does not include prescription drug coverage — it’s paired with a separate Part D plan
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Cannot be combined with a Medicare Advantage plan
Medicare Advantage Plans
(MA/MAPD)
Medicare Advantage plans are an alternative way to receive your Medicare benefits, offered through private insurance companies approved by Medicare.
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Often includes extra benefits like dental, vision, hearing, and sometimes fitness or wellness perks
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PPO and HMO options are available, coverage is dependent on specific provider networks
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Most include prescription drug coverage built in
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Usually works within a network of doctors and hospitals, and may require referrals for specialists
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Costs vary by plan, with set cost-shares and co-payments for services
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Plans differ by location, so what’s available depends on where you live
Prescription Drug Plans
(PDP)
A standalone Part D plan that covers prescription medications. PDPs are designed for people who have Original Medicare with or without a Medigap plan, since Medigap alone doesn’t include drug coverage.
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Covers prescription medications, with costs based on each plan’s drug list (formulary)
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Premiums, copays, and covered drugs vary by plan and by pharmacy
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Paired with Medigap (not needed if you already have a MAPD plan, since drug coverage is built in)
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Each year you should review your plan’s drug list, or formulary, to see if they cover your prescriptions
THE KEY DIFFERENCE
Medigap and Medicare Advantage are two different paths — not add-ons to each other. Medigap pairs with Original Medicare for maximum flexibility in choosing providers, usually with a higher monthly premium and lower costs at the time of care. Medicare Advantage often has a lower (sometimes no-cost) monthly premium and built-in extra benefits, with more structure around networks and referrals. Neither option is universally “better” — the right fit depends on your health needs, budget, and preferences.