What's Medicare Advantage (Part C)?
Medicare Advantage (also known as Part C) plans include everything that Original Medicare offers. But they also include benefits such as dental, vision and hearing coverage. Here are some other benefits Medicare Advantage plans may include:
What's a Medicare Supplement (Medigap) insurance plan?
Medicare Supplement insurance plans (also known as Medigap plans) help cover out-of-pocket costs that Original Medicare does not. Instead of adding coverage, Medicare Supplement insurance plans can help support existing coverage. Here are some examples of costs Medicare Supplement insurance plans can help with:
- Medicare deductibles
- Medicare copays
- Medicare coinsurance
Learn more about when to consider Medicare Supplement insurance plans
Compare Medicare Advantage vs. Medicare Supplement insurance plans
The chart below lays out the key differences between Medicare Supplement insurance (Medigap) and Medicare Advantage (Part C) plans.
| Plan features | Medicare Advantage | Medicare Supplement |
|---|---|---|
| Coverage | All-in-one plan that includes Medicare Part A (hospital insurance) and B (medical insurance); may also include Part D (prescription drug coverage) | Helps cover out-of-pocket costs from Original Medicare |
| Enrollment | Enroll through private insurers during specific enrollment periods | Enroll through private insurers. It’s best to enroll during the Medigap Open Enrollment Period. This is a one-time, 6-month window that starts the first month you have Medicare Part B and are 65 or older. If you’re under 65, eligibility varies by state. If you don’t enroll during this time and you don’t have a guaranteed issue right, you may pay more or be denied a policy. A guaranteed issue right is a short period when you can enroll in Medigap after your coverage changes. |
| Provider network | Typically uses networks (e.g., HMOs, PPOs); may need to see in-network providers | No network restrictions; see any doctor who accepts Medicare |
| Referrals | May be required to see specialists (especially in HMO plans) | No referrals needed to see specialists |
| Costs | Monthly premiums as low as $0; cost-sharing (copays, coinsurance) may apply | High monthly premiums; little to no out-of-pocket costs after premium |
| Prescription drug coverage | Usually included (MAPD plans) | Not included; must purchase a separate Part D plan |
| Out-of-pocket expenses covered (deductibles, copays, coinsurance) | Has an annual out-of-pocket maximum | Covers most Medicare deductibles, copays and coinsurance |
| Additional coverage – Dental, Vision, Hearing | Often included | Not included |
| Free programs and services – Fitness | May include fitness benefits | Not typically included |
| Medical underwriting | Not required | May be required if enrolling outside of Medigap Open Enrollment Period |
Who’s eligible for Medicare Advantage?
Just like the process to enroll in Medicare, there are rules to be eligible for Medicare Advantage.
You must be:
- Enrolled in Medicare Part A
- Enrolled in Medicare Part B
- Living in the plan’s service area
- A US citizen or lawfully present in the US
- Under 65 and disabled, suffering from end-stage renal disease or living in Texas with Amyotrophic Lateral Sclerosis (ALS)
Who’s eligible for Medicare Supplement insurance plans?
Medicare Supplement insurance plans also have requirements. You must be:
At least 65 years old (Different conditions and restrictions may apply in some states)
Enrolled in Medicare Part A
Enrolled in Medicare Part B
Living in a state where your policy is offered
How much do Medicare Advantage plans cost?
Medicare Advantage costs vary by plan and may change each year. You'll need to keep paying your Medicare Part B premium because it's a part of your total cost. Costs also include deductibles, copayments, coinsurance and any additional premium your plan requires. Your out-of-pocket limit for the year varies by plan. But once you reach it, your plan will pay for the rest of covered medical services until the end of the year.
How much do Medicare Supplement insurance plans cost?
Medicare Supplement insurance plans premiums vary depending on your insurer, your plan and where you live. These costs are generally higher if the plan has more coverage and lower if it has less. Your Medicare Supplement insurance plans costs may be kept lower if your plan has an out-of-pocket limit (some do).
Learn more about Medicare Supplement insurance plans in your state
Can I have a Medicare Advantage and Medicare Supplement insurance plan at the same time?
You can’t enroll in Medicare Advantage and Medicare Supplement insurance plans at the same time. Medicare Supplement insurance plans are meant to work with Original Medicare, while Medicare Advantage plans replace it.
Can I switch from one Medicare plan to another?
You can switch Medicare plans during specific enrollment periods.
If you’re switching from a Medicare Advantage plan to a Medicare Supplement insurance plan, you can do so during the Open Enrollment Period (January 1 – March 31) or the Annual Enrollment Period (October 15 – December 7). To enroll in a Medicare Supplement insurance plan outside of the Medigap Open Enrollment Period, you may need medical underwriting.
To switch from a Medicare Supplement insurance plan to a Medicare Advantage plan, use the Annual Enrollment Period.
Learn more about different Medicare enrollment periods
Disclaimers
Aetna is the brand name for insurance products issued by subsidiary insurance companies. The Medicare Supplement Insurance Plans are insured by Continental Life Insurance Company of Brentwood, Tennessee, American Continental Insurance Company, Aetna Health and Life Insurance Company, or Aetna Health Insurance Company.
Not connected with or endorsed by the U.S. Government or the Federal Medicare Program.
This is a solicitation of insurance. Contact may be made by a Licensed Insurance Agent or Insurance Company.