If you're ready to enroll in Medicare, or if you're already enrolled but not sure you have the right type of coverage, you may be wondering whether to choose a Medicare Advantage (MA) plan or go with Original Medicare and pay for Medicare Supplement (Medigap) insurance to cover extra costs.

While 澳洲幸运5官方开奖结果体彩网:Medicare Advantage plans tend to have low or no monthly premiums and offer extra benefits, they restrict your choice of providers and require preauthorization for high-cost treatments, which can delay care. You won't have those obstacles if you choose Original Medicare with a Medigap plan, but you'll pay quite a bit more every month.

Medicare Coverage and Its Gaps

Original Medicare includes 澳洲幸运5官方开奖结果体彩网:Part A (hospital insurance) and 澳洲幸运5官方开奖结果体彩网:Part B (medical insurance). Both parts have deductibles, copays or coinsurance, and Part B has a monthly premium. Unlike coverage under the 澳洲幸运5官方开奖结果体彩网:Affordable Care Act (ACA), Original Medicare does not impose an annual 澳洲幸运5官方开奖结果体彩网:out-of-pocket limit. So, you'll continue to pay these cosꦯts regardless of how much they add up to in a year.

For example, let's say that you need heart bypass surgery. The total costs could exceed $150,000. If the surgery is successful and you recuperate well, you could still face thousands of dollars in 澳洲幸运5官方开奖结果体彩网:coinsurance, copayment, and 澳洲幸运5官方开奖结果体彩网:deductible costs. If you run into complications, your costs could run much higher, especially if you require more than 60 days of hospitalization.

Additionally, certain health needs, such as prescription drugs, hearing aids, eyeglasses, and dental care, are not covered by Original Medicare.

To fill coverage gaps, you have two options. You can enroll in Original Medicare and purchase a Medigap supplemental policy and a 澳洲幸运5官方开奖结果体彩网:Part D plan for 🤡drug coverage, 𒁏or you can choose a Medicare Advantage plan. 

Medicare Plus Medigap Sup𓆉plemental Insurance Policies

About 46% of the 60.6 million Medicare beneficiaries choose Original Medicare, which covers hospitalization, doctor fees, and other medical costs. To be clear, you can stick with that and buy nothing else. You don't have to add Medigap coverage—only 42% of Medicare recipients did in 2022. But another 47% had other kinds of supplementary insurance such as Medicaid or employer-sponsored insurance. If you don't hav♏e those options🍨, Medigap is recommended in most situations if you can afford it.

While sꦓupplementing Medicare with a Medigap policy may be the more expensive option, it has some dist💎inct advantages:

• Both Original Medicare and 澳洲幸运5官方开奖结果体彩网:Medigap insurance plans allow you to seek services from any doctor or hospital in the United States that accepts Medicare.
• Original Medicare and Medigap do not require prior authorization for the vast majority of procedures, or a referral from a primary care doctor.
• Coverage extends throughout the United States, an important benefit for people who travel frequently and those who own multiple homes in different states.

Medicare Advantage Plans

Available through private, Medicare-approved insurance companies, Medicare Advantage policies (also known as Medicare Part C) are marketed to consumers by companies like Aetna, Humana, and Kaiser Permanente.

Many Medicare Advantage plans have a $0 premium or a lower premium than most Medigap plans. The average Medicare Advantage premium is projected to be $17 in 2025, while 澳洲幸运5官方开奖结果体彩网:Medigap premiums may run anywhere from around $65 to $450, depending on the 澳洲幸运5官方开奖结果体彩网:type of Medigap plan you choose and your location.

Medicare Advantage plans include Medicare Parts A and B, and many include Part D. Many Medicare Advantage plans also include benefits such as limited dental, hearing, and vision care coverage, which are not covered by Original Medicare.

Most Medicare Advantage plans operate as a 澳洲幸运5官方开奖结果体🌃彩网:health maintenance organization (HMO) or a 澳洲幸运5官方开奖结果体彩网:prefer🍸red provider orಌganization (PPO).

In addition to no or lower premiums, Medicare Advantage plans differ from Original Medicare and Medigap plan൩s in other ways:

• HMOs require members to use doctors and hospitals in their networks.
• PPOs generally let members seek services outside the plan's network, but members may have to 澳洲幸运5官方开奖结果体彩网:pay more for such care.
• Plans typically require you to get a referral from a primary care doctor if you need to see a specialist for care.
• Some 99% of all MA enrollees must get prior authorization for some services, usually costly ones, such as inpatient hospital stays, skilled nursing facility stays, and chemotherapy.
• Plans might not cover care provided outside of the network’s geographical area.

When to Sign Up for Medicare

Whichever route you decide to take, you'll need to first be enrolled in traditionalඣ Medicare. As you approach age 65, it’s important to know which enrollment deadlines apply to you. Begin by checking your 𒀰.

To avoid coverage gaps and costly penalties for not enrolling on 𝓀time, most people should  for Medicare Parts A and B in the seven-month win🍸dow that starts three months before they turn 65.

🅰 If you currently receive Social Security bene♚fits, you will be automatically enrolled. If not, you can or at your local Social Security office.

Delaying Medicare Part B

If you turn 65 and you're covered by an employer health insurance plan (yours or your spouse's), you can delay Medicare Part B enrollment as long as you have that coverage. Once the employer coverage ends, you can qualify for a Medicare Part B special enrollment period, which extends for eight months after the job or coverage ends (whichever comes first).

Medicare Part D

Once you’ve enrolled in Medicare, you can sign up for Medicare Part D prescription drug coverage. If you don’t enroll in Part D during the Medicare open enrollment period and decided to enroll later, you'll end up paying an ongoing penalty once your drug coverage begins. Medicare bases the amount of the penalty on the number of months you went without Part D coverage after your Medicare benefits began. So, the longer you wait, the higher the penalty you'll pay.

You can avoid the penalty, however, if you have 澳洲幸运5官方开奖结果体彩网:cr🔯editable prescription drಞug coverage—coverage provided by an employer or union, for example. To qualify as creditable coverage, it must pay, on average, at least as much as Medicare’s prescription drug benefit. 

Generally, you can keep this kind of drug coverage when you become eligible for Medicare. If you decided to keep a creditable prescription drug benefit and later decide to enroll in a Medicare prescription drug plan, you won't pay a penalty if you haven't gone more than 63 continuous days without creditable coverage.

Choosing Original⛄ Medicare Plus Part D and Medigap🍸

When signing up for Medicare Parts A and B, you'll have the option to enroll in a standalone Medicare Part D prescription drug plan and a Medigap supplemental insurance plan. You can also add Part D during Medicare open enrollment, which runs from Oct. 15 to Dec. 7 each year.

Selecting Part D Drug Insurance

To get started, go to Medicare.gov and look for plans available in your ZIP code. After creating a Medicare account, you can enter the names of your prescription drugs and  plan premiums, deductibles, and Medicare star ratings.

If you don’t take many (or any) prescription drugs, consider a plan with a low monthly premium. All plans must cover drugs most commonly🐠 needed by Medicare enrollees.

As a provision of the Inflation Reduction Act, beginning in 2025, Medicare has eliminated the so-called 澳洲幸运5官方开奖结果体彩网:Part D donut hole and will cap your out-of-pocket drug costs at $2,000. This gets rid of the coverage gap that past Medicare enrollees experienced.

Selecting a Medigap Supplemental Plan

Medigap policies are plans available through private insurance companies, but they are not on Medicare's site. Plans are labeled A, B, C, D, F, G, K, L, M, and N, and each offers a different standardized coverage. For example, every Plan G policy must offer the same basic coverage, but some plans may offer more, and costs may vary among providers.

Plan F and Plan G offer high-deductible options in some states. Some, but not all, plans include emergency medical benefits 澳洲幸运5官方开奖结果体彩网:during foreign travel.

Standardization of plans lets you confidently compare insurers’ prices for each lettered plan, allowing you to concentrate on choosing the plan that best fits your needs. Medigap p𒈔lans do not have Medicare star ratings.

All plans cover Part A coinsurance and hospital costs (up to 365 days) after you exhaust your Part A benefits. Most plans also cover your Part B coinsurance and copayment costs. Plan F provides the most comprehensive coverage, including payment of your annual Medicare Part B deductible ($240 in 2024).

However, Plans C and F are not available to people who turned 65 on or after January 1, 2020. If you were Medicare-eligible prior to 2020, but did not enroll, you may be eligible for Plans F and C when you do enroll. Plan D and Plan G have similar benefits to Plan C and Plan F, but they don't cover the Part B deductible.

You can 澳洲幸运5官方开奖结果体彩网:enroll in Medigap in the first month that you are 65 years old and enrolled in Medicare Part B. The enrollment period extends for six months, during which time you can switch to a different Medigap plan if you choose. If you switch, you have a 30-day "free look period" to decide if you want to cancel or keep it.

Choosing a Medicare Advantage Plan

Medicare Advantage plans must provide Part A and B coverage, and most include prescription drug coverage. But other factors vary. Some require a referral to see a specialist, while others do not. Some may pay a portion of out-of-network care, while others will cover only doctors and facilities within an HMO or PPO network. And costs such as premiums🍎, deductibles, copays, and out-of-pocked maximums are all different across plans.

Plan Your Selection With Care

Selecting a plan with a $0 or low annual premium can be important. But it's also essential to analyze costs such as copayments, coinsurance, and hospitalization costs to🍃 get an accurate estimate o🐭f your annual expenses.

Since care is often limited to in-network physicians and hospitals, the quality and siz🌳e of a particular plan’s network also should be an importaꦍnt factor in your choice. 

Head to  at Medicare.gov to start your search.𒈔 The "Compare" tool lets you see a side-by-side comparison.

The 澳洲幸运5官方开奖结果体彩网:National Committee for Quality Assur🍸ance (NCQA), an insurance rating organization, tracks what consumers think of Medicare Advantage plans' services and physicians, and whether plans meet certain quality standards.

In 2024, only two Medicare Advantage plans earned a 5-star rating from the NCQA, 25 earned 4.5 stars, and 123 earned a 4-star rating. Be sure to check the .

Key Differences: What to Consider When Choosing

Your lifestyle, health, and finances may play roles in determining the best type of plan for💦 you: Original Medicare plus Medigap or Medicare Advantage. Here are a few things to consider:

Costs

Often, Medicare Advantage plans o꧂ffer lower premiums, especially if they include prescription drug coverage. If not, you’ll need to buy a separate Part D plan.

Review the cost of premiums, copays, and other out-of-pocket expenses, along with cove🌺rage limits. If a plan includes extra benefits, like dental or vision services, assess how much of the costs it covers. Typically coverage is limited.

Compare all the associated costs of a Medigap plan versus Original Medicare with Medicare Part D. For each plan, calculꩵate all costs, including premiums, coinsurance, copayments, and deductibles.

Choice of Doctors 

Origiꦉnal Medicare allows you to seek services from any U.S. doctor or hospital that accepts Medicare. Most Medicare Advantage plans restrict you to in-network service providers and may cover less, orไ none, of the costs of using out-of-network providers.

Under Medicare Advantage HMO plans, you must get a referral from your primary doctor to seek specialist care. Medicare Advantage PPO plans, however, do not require a referral. Original Medicare doesn't require a referral to see a specialist.

Local Conditions and Convenience

Availability of doctors and hospitals can vary by location. When🌱 choosing a Medicare Advantage plan, rural residents may have fewer options than urban dwellers. Compare plans to find one that has providers you can easily access.

Lifestyle Factors 

Original Medicare might provide the best coverage if you travel frequently within the United States, have multiple residences in different states, or want to keep you current doctor. If you're not yet enrolled in Medicare and want to remain with your current physician, ask them if they participate in any Medicare Advantage plans or accept Original Medicare.

If you travel abroad, consider choosing Original Medicare plus a Medigap plan that covers emergency care in foreign countries. Due to network restrictions, a Medicare Advantage plan might not offer the coverage you need if you travel outside your state.

Your Health

If you have a chronic condition, review the out-of-pocket limits of Medicare Advantage plans, which could protect you from exorbitant costs. You may also want to see if you're eligible for a 澳洲幸运5官方开奖结果体彩网:Medicare Advantage Special N🌜eeds Plan. Some of these offer targeted coverage for people with particular chronic conditions, such as cancer or di🌸abetes.

However, Originaဣl Medicare plus Medigap generally allows you more provider choices and may offer more coverage for specialist care.

Revi🍎e𒁃w the cost of drugs and equipment (such as diabetic supplies) to determine whether a plan will meet your needs.

More Benefits

Do you think you would really use the extra benefits such as vision and hearing coverage that come with many Medicare Advantage plans? A 2024 Commonwealth Fund survey found that three out of 10 MA recipients didn’t use any available benefits. Medicare is so concerned about unused benefits that in 2025, it will require MA insurers to send letters to recipients mid-year listing any supplemental benefits they haven't used in the first six months of the year.

Often, supplemental benefits provided with MA plans offer limited coverage and may have high coinsurance rates. Prior to annual open enrollment periods, review any coverage you're considering and compare it to other available options.

Can You Switch? Yes, But There’s a Catch

Your health care needs can change over time, due to medical conditions or your lifestyle. The cost savings of a Medicare Advantage plan might be a good choice while you're relatively healthy, but as you age, you may want more choice in specialist providers with less hassle from preauthorization requirements. And if you're healthy and want to hit the road, you might need Original Medicare to cover your health care needs while away from home.

澳洲幸运5官方开奖结果体彩网✃:Switching between the two forms of Medicare (or between Medicare Advantage plans) is an option for everyone during the annual open enrollment period, which runs from Oct. 15 to Dec. 7 each year.

Switching Back to Original Medicare

If you switch from a Medicare Advantage plan back to Original Medicare (Parts A and B), you must also sign up for Medicare Part D at the same time if you think you'll want drug coverage. Otherwise, you could incur a Part D late enrollment penalty.

And private insurers may deny you Medigap coverage if you have a pre-existing condition. In some cases, the provider will approve you for Medigap coverage, but at a h🦹igher rate. When you first enroll in Medicare Parts A and B, Medigap providers must of♊fer you a policy, regardless of your medical condition. But they are not required to provide Medigap coverage after your initial enrollment period.

Some states have enacted laws to address this. In Connecticut, for example, Medigap insurance plans are 澳洲幸运5官方开奖结果体彩网:guaranteed-issue year-round, so insurers must provide coverage to anyone without medical underwriting.

If you live in a state that doesn't offer this protection, switching between a Medicare Advantage plan and Original Medicare might pose a risk.

Frequently Asked Questions (FAQs)

The Bottom Line

Before deciding on a Medicare Advantage plan or Original Medicare with Medigap, take the time to conduct a thorough analysis. Each ty🧸pe of plan has distinct advantages and disadvantages.

While cost is important, also consider your personal preferences and health care needs. If you want to keep your current doctor or you worry about having a good choice of providers in the future, Original Medicare with Medig𝐆ap might be your best choice. But if cost is your biggest concern, you might need a Medicare Advantage plan.

Generally, after your initial enrollment in Medicare, you must wait until the Medicare open enrollment or 澳洲幸运5官方开奖结果体彩网:Medicare Advantage open enrollment periods to switch plans. Make sure you know when open enrollment periods begin and🍰 end. Also, learn more about the penalties and consequences of enrolling late or changing from one type of plan to another.