Insurance | November 24, 2025
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As you near Medicare eligibility, the flood of information can feel overwhelming. The key is understanding your core options: Original Medicare, Medicare Advantage, and Medicare Supplement (Medigap) plans. Each choice impacts your provider access, costs, and flexibility.
Original Medicare: The Foundation
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). It’s managed by the federal government and accepted by any doctor or hospital that takes Medicare in the U.S. In most cases, you don’t need referrals to see specialists.
However, Original Medicare doesn’t cover everything. You’re responsible for deductibles, coinsurance, and certain services like dental, vision, or long-term care. That’s where Medicare Supplements (Medigap) or Medicare Advantage plans come in.
Medicare Supplement (Medigap): Filling the Gaps
Medicare Supplement plans (often called Medigap) are sold by private insurers to help cover the “gaps” in Original Medicare.
They pay some or all of your out-of-pocket costs, such as copayments, coinsurance, and deductibles. Plans are standardized (Plan A, G, N, etc.) and must follow federal and state laws, ensuring consistent coverage across insurers.
Key features of Medigap:
- You can see any doctor or hospital that accepts Medicare.
- No referrals required to see specialists.
- Does not include prescription drug coverage (Part D must be purchased separately).
- Premiums vary by state, age, and ZIP code.
IMPORTANT TIP
Some Medigap policies also include wellness or fitness program benefits. These extras are not guaranteed with all plans, but you can verify with your insurance agent whether your specific Medigap policy offers this benefit.
Medicare Advantage: All-in-One Simplicity
Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare. These plans bundle your Part A and Part B coverage and often include Part D prescription drug coverage, dental, vision, and wellness extras.
Unlike Original Medicare, you typically must use network providers. Most plans require referrals to see specialists, and your out-of-pocket costs vary based on copays and services. However, these plans include an annual out-of-pocket maximum, capping what you’ll spend in a year.
Key advantages of Medicare Advantage:
- Many plans have $0 premiums (you still pay your Part B premium).
- Extra benefits like dental, vision, hearing, and fitness programs.
- Budget protection through annual cost limits.
| Feature | Medicare Supplement (Medigap) | Original Medicare | Medicare Advantage |
|---|---|---|---|
| Provider Flexibility | Any provider that accepts Medicare | Any provider that accepts Medicare | In-network (most plans) |
| Drug Coverage | Not included (add Part D) | Not included | Usually included |
| Specialist Access | No referral needed | No referral needed | Referral often required |
| Out-of-Pocket Limit | A Medicare deductible may apply | No set limit | Annual max limit set |
| Premiums | Higher monthly | Standard Part B premium | May be lower or $0 |
| Best For | Frequent travelers, high care users | Basic federal coverage | Cost-conscious enrollees |
Get Help Choosing Your Medicare Path
Deciding between Medicare Advantage and Medicare Supplement is a personal choice based on your care preferences, travel habits, and financial comfort. The agents at Forward Insurance can help you compare plans and understand your options so you can make an informed, confident choice. Book an appointment online with a health insurance agent today to explore your options