What is Medicare Advantage?

Medicare Advantage (also called Part C) is private health coverage that replaces Original Medicare (Part A and Part B) for your Medicare benefits. These plans are offered by insurance companies approved by Medicare and often include additional benefits beyond Original Medicare.

Most Medicare Advantage plans may include:

• Coverage for hospital and medical services (Medicare Part A & Part B benefits)
• Prescription drug coverage (Part D) in many plans
• Extra benefits that may include dental, vision, hearing, OTC allowances, fitness benefits, and more (benefits vary by plan and county)
• An annual out-of-pocket maximum (limits what you pay for covered medical services in a year)

Why do people choose Medicare Advantage plans?

Medicare Advantage can be a strong fit for people who want coverage that’s simple, bundled, and designed to manage costs.

Common reasons people consider Medicare Advantage:

• All-in-one coverage (many plans combine medical + prescription coverage)
• Copays instead of large coinsurance in many situations
• Extra benefits not included with Original Medicare
• Budget-friendly options may be available depending on your area and eligibility
• Protection with an out-of-pocket maximum

We believe in helping you make a clear decision—so we always review the important details.

Medicare Advantage plans may include:

• Provider networks (HMO/PPO rules vary)
• Referrals for specialists on certain plans
• Prior authorizations for some services
• Copay structures that can differ based on care type (primary care, specialists, ER, inpatient, etc.)
• Travel coverage differences compared to other Medicare options

Our job is to help you understand these items upfront so there are no surprises later.

 Not sure if Medicare Advantage is right for you? We’ll help you compare it with other options (like Medigap) and choose what fits your situation.

What are Medigap plans?

Medigap (also called Medicare Supplement Insurance) is additional coverage that works alongside Original Medicare (Part A and Part B). Medigap helps pay certain out-of-pocket costs like copays, coinsurance, and deductibles depending on the plan you choose.

Medigap is often a great option for people who:

• Want more predictable costs throughout the year
• Prefer broad provider access without HMO/PPO networks
• Travel frequently or live part-time in more than one location
• Want coverage that’s straightforward and easy to use

Important notes:

• Medigap plans are standardized by plan letter (availability varies by state and eligibility).
• Medigap typically has a monthly premium.
• Medigap generally does not include prescription drug coverage—you usually pair it with a Part D plan.

Why People Choose a Medicare Supplement

Many people choose Medigap because it can make Medicare expenses easier to plan for.

Common benefits of Medigap:

• Nationwide access to providers who accept Medicare
• Lower out-of-pocket exposure for Medicare-approved services (depending on the plan)
• Fewer surprises when you need care
• Coverage that works well for people who want stability and flexibility

We’ll help you look at the full picture—not just the premium.

Key considerations:

• Medigap plans usually have a monthly premium
• You’ll generally need a separate Part D plan for prescriptions
• Some Medigap plans may have medical underwriting outside certain enrollment windows (eligibility rules apply)
• The “best” plan depends on how often you use care and how predictable you want costs to be

Medigap vs Medicare Advantage: Which One Is Better?

Medigap (Supplement) may be best if you:

• Want broad provider access (no networks)
• Prefer predictable costs when using care
• Travel frequently or want flexibility
• Don’t mind paying a monthly premium for stronger cost protection

Medicare Advantage may be best if you:

• Want an all-in-one plan structure
• Prefer copays and plan-based benefits
• Want extra benefits (dental/vision/hearing) where available
• Are comfortable using provider networks

We can compare both options and help you choose the best fit.

What are Medicare Prescription Drug Plans (Part D)?

Medicare Prescription Drug Plans—often called Part D—provide coverage for prescription medications. These plans work alongside Original Medicare (Part A and Part B) or certain Medicare Supplement (Medigap) plans to help reduce the cost of prescriptions.

Part D plans are offered by private insurance companies approved by Medicare and cover both brand-name and generic medications, based on each plan’s formulary.

Part D is often a great option for people who:

• Take prescription medications regularly
  
  
• Want help managing rising drug costs
  
  
• Are enrolled in Original Medicare or a Medigap plan
  
  
• Want protection from high out-of-pocket prescription expenses
  
  

Important notes:

• Part D plans are stand-alone plans and are optional, but late enrollment penalties may apply
  
  
• Each plan has its own drug list (formulary), pharmacy network, and cost structure
  
  
• Part D plans typically have a monthly premium (some plans may be low-cost or $0)
  
  

Why People Choose a Medicare Prescription Drug Plan

Many people choose Part D coverage to make prescription costs more manageable and predictable throughout the year.

Common benefits of Part D plans:

• Coverage for many commonly prescribed medications
  
  
• Lower out-of-pocket costs at participating pharmacies
  
  
• Protection against very high drug expenses
  
  
• Options to choose plans that best fit your medications and budget
  
  

Prescription coverage is not one-size-fits-all—plans can vary significantly.

That’s why we help you look beyond just the premium.

Key considerations:

• Not all plans cover the same medications
  
  
• Costs can vary by pharmacy and drug tier
  
  
• Formularies can change from year to year
  
  
• Enrollment deadlines and penalties matter
  
  
• The “best” plan depends on your specific medications, dosages, and pharmacy preferences
  
  

Medicare Part D vs Medicare Advantage Drug Coverage

Prescription drug coverage can be obtained in two primary ways.

A stand-alone Part D plan may be best if you:

• Have Original Medicare or a Medigap plan
  
  
• Want flexibility to pair drug coverage with your existing Medicare setup
  
  
• Prefer to choose a drug plan based solely on your prescriptions
  
  

Medicare Advantage with drug coverage (MAPD) may be best if you:

• Want an all-in-one plan that includes medical and drug coverage
  
  
• Prefer bundled benefits under one plan
  
  
• Are comfortable with plan networks and cost-sharing