Medicare Advantage vs. Medicare Supplement: Which Is Right for You During Open Enrollment?

The choice between Medicare Advantage and Medicare Supplement plans shapes how your health insurance enables you to access care and manage out-of-pocket costs for the year ahead. These two paths offer fundamentally different structures, and choosing the right one for your situation can make a significant difference in the providers you can access and what you pay for care.

How the Two Plans Work

Medicare Advantage (Part C) bundles hospital, medical and often prescription drug coverage through a private insurer. Medicare Supplement plans, also called Medigap, work alongside Original Medicare (Parts A and B) to assist with out-of-pocket costs like copayments, coinsurance and deductibles. They are separate products with different cost structures, networks and flexibility.

Consider these specific differences:

• Provider networks: Medicare Advantage plans typically use health maintenance organization or preferred provider organization networks, limiting which doctors you can see. Medigap plans generally allow you to visit any provider that accepts Medicare.
• Prescription coverage: Medicare Supplement plans do not include drug coverage, so you would need a separate Part D plan. Many Medicare Advantage plans include prescription benefits.
• Predictability: Medigap tends to offer more predictable out-of-pocket costs. Medicare Advantage plans may carry lower premiums but higher variable costs depending on the care you use.
• Enrollment timing: Medigap has guaranteed issue rights at certain times, but outside those windows, medical underwriting may apply. Once your initial six-month Medigap open enrollment period closes, switching plans will generally require passing medical underwriting.
• Covered services: Medicare Advantage plans often include additional benefits, such as for vision, dental and hearing care, whereas Medicare Supplement plans do not provide coverage for additional services on top of Parts A and B.

When Open Enrollment Matters

The Medicare annual open enrollment runs Oct. 15 through Dec. 7 each year, during which anyone with Medicare can review and make changes to their coverage. There is also a separate Medicare Advantage open enrollment period from Jan. 1 through March 31, available only to those already enrolled in a Medicare Advantage plan who wish to make a change or return to Original Medicare.

Make the Right Call Before Enrollment Closes

The right Medicare plan depends on your health needs, preferred providers and how you budget for medical costs. Contact My One Stop Insurance Agency to compare your options and find the right coverage.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.