Key Takeaways:

• Medigap helps fill in the gaps for out-of-pocket deductibles, coinsurance and copayments.
• Medicare Advantage plans have a more limited network of providers than Original Medicare.
• The federal government standardizes benefits within each Medigap plan. However, private insurance companies offer these plans at varying rates.
• Medigap plans F, G and N are the most popular.
• When comparing Medigap providers, consider costs, coverage and accessibility to important health providers.
• If your Medicare Advantage plan promises to cover prescription drugs, call your health providers to confirm that they accept the plan.

What is the Difference Between Medigap and Medicare Advantage?

• Medigap — Medigap is also known as a Medicare Supplement plan. It is offered through private companies to fill gaps in your Original Medicare cover. Traditional Medicare coverage includes Part A (hospitals) and Part B (doctors). It pays only about 80% of health costs.

Medigap provides a way to reduce the financial burden of out-of-pocket deductibles, coinsurance and copayments. As a result, Medigap supplements your Original Medicare coverage. You have more provider choices if you stay with Original Medicare's Part A and Part B options then add Medigap.

• Medicare Advantage — On the other hand, private companies offer Medicare Advantage plans (also known as Medicare Part C). These provide Part A and Part B benefits. Depending on your provider and plan choice, you may have more benefits. Common extra benefits include routine vision and dental care, prescription drug cover, hearing aids, and fitness plans. Compared to Original Medicare, Medicare Advantage plans have a more limited network of providers.

This brings your Medicare coverage down to four choices:

• Original Medicare, which covers hospital visits and doctors. Patients must pay deductibles, coinsurance and copays out of pocket
• Original Medicare plus Medigap to cover out-of-pocket costs
• Original Medicare plus Medigap and Part D cover out-of-pocket costs and prescribed drugs
• Medicare Advantage from an approved private insurance company for Part A and Part B benefits. Some plans cover prescription drugs.

How Do You Review Medigap Plans?

Medigap plans defer by benefits. The federal government standardizes benefits within each plan. However, private insurance companies offer these plans at varying rates. Your annual review of Medigap plans should consider your health needs, coverage and rates. The right choice for you should include your important physicians in network. Out-of-pocket costs should be manageable. If you often travel, confirm that your Medigap option has a wide network.

Below, we summarize benefits of Medicare plans A–N.

Medigap Plan Benefits Review

The summary excludes Medicare plans E, H, I and J. These plans are no longer sold. Among available plans, options F, G and N are the most popular. This is because plans F and G have full benefits that limit out-of-pocket costs. The only difference between plan F and plan G is the Part B deductible, which is charged to plan G members. Plan N is popular because it has lower premiums.

*Unlike plans F and G, plan N has higher out-of-pocket costs. These charges include $0–$20 copays for doctor visits. If an emergency room visit does not lead to admission it costs up to $50 in copayment. Plans C and F were not available to new enrollees from January 1, 2020. However, if you were already eligible for Medicare Part A before 2020, you will continue to have the option of enrolling in plans C and F.

What Should I Do If My Plan Will No Longer Be Offered?

If you are already in a plan that will no longer be offered in 2020, you may keep it. These plans will continue to be phased out. You should still review updated plans. Compare their market rates and health benefits. Consider plan G if you like the benefits of plan F but will not be eligible to sign up.

Medigap Plan Providers Review

The federal government keeps plan benefits standard. When reviewing your options, pay attention to costs, coverage and accessibility to important health providers. The private insurance company you choose should have stable, low rates with quality service. Some providers alter rates more often than others. Below is a sample of popular Medigap providers:

• Cigna — This provider has low cost plans and wide coverage within the United States. Some plans have foreign coverage.
• Humana — Popular for round-the-clock access to a nurse through a phone call. Humana has wide national and some foreign coverage.
• Blue Shield Blue Cross — Popular for wide coverage. It provides cost saving opportunities through quitting smoking, healthy diet and electronic payments.
• AARP United Healthcare — AARP MedicareRx plans through Walgreens are popular for full coverage of prescription drugs.
• Aetna — Popular for low rates on Medicare plan A and B, and medical emergencies during foreign travel.
• Mutual of Omaha — The Medigap plan G option offered by Mutual of Omaha is popular. This is because of low out-of-pocket costs. It is a common alternative to plan F.

How Do I Review Medicare Advantage Plans?

Compare out-of-pocket costs through copays, deductibles and coinsurance. If your plan promises to cover prescription drugs, call your health providers to confirm that they accept the plan. Check that your medication will be covered and that the plan you choose is tailored to your needs.

The National Committee for Quality Assurance (NCQA) and the Center for Medicare and Medicaid Services (CMS) use a 5-star review system. The goal is to help seniors compare the quality and suitability of health plans. Avoid plans that have lower than 3 stars. Plans with the maximum 5-star rating have excellent performance and outcomes. The metrics below review Medicare Advantage plans:

• Customer satisfaction and experiences
• Trends of performance and improvement of the plan
• Management of chronic conditions
• Screenings or check-ups that help plan beneficiaries stay healthy
• Costs and network coverage of providers

When Can I Review and Make Changes to My Medicare Coverage?

Open Enrollment — Your first chance to review your Medicare options is during the Open Enrollment Period. This is three months before you turn 65, your birthday month and three months after. During this time, you must enroll in Medicare Part A and may add Part B. To fill gaps in your Original Medicare cover, Medicare Supplement insurance plans (Medigap) has another six months Open Enrollment Period. This will begin the month you turn 65, and enroll in Medicare Part B.

Yearly Review — Plans change from year to year. If you are over 65 and have signed up for Medicare Part A and Part B, you get a yearly chance to review and switch to a different Medicare health plan. Health needs also evolve. In September and October of each year, you can review then switch plans. Open enrollment begins on October 15, usually ending on December 7 . This allows you to change health and prescription health plans. Plan switches, and current plan updates take effect the next year on January 1.

Change Medicare Advantage Plans — January 1 to March 31 is another important decision period for plan reviews. If you have a Medicare Advantage plan, you can switch to a different Medicare Advantage plan. You can also switch from a Medicare Advantage plan to Original Medicare with or without a Medicare prescription drug plan. Changes take effect the first day of the month after receipt of your enrollment form.

Special Enrollment — If you have a life event that qualifies you for the Special Enrollment Period, you can make more changes. The Special Enrollment Period is an eight-month period that begins the month after your employment ends. It may start when the month group health plan (provided by your employer) ends. As a disclaimer, you are not eligible for Special Enrollment if you signed up for COBRA.

Reviews of Medicare Advantage Insurance Providers

Although Medicare Advantage plan reviews vary by zip code, health needs and personal finances, the below providers generally rank highly according to CMS.

Next Steps To Take

Researching the different Medicare plans and weighing the pros and cons of each will help you decide how to best fulfill your health care needs. Conducting your own research, having all the facts, and recognizing what your needs are before speaking with a licensed insurance agent will help empower you when it's time to choose the right plan for you.

Grace Kisirkoi works in higher education and is a writer who specializes in finance.