What's The Difference?:
Medigap vs MAPD?
- Medigap: known as Medicare Supplement plans
- MAPD: known as Medicare Advantage Health plans, also referred to as Part C.
- Medigap: All hospitals and ~95% of providers in America accept medigap plans.
- MAPD: Networks vary carrier to carrier, plan to plan. Doctor and provider networks can be limited to just NJ access.
- Medigap: Plan benefits are standardized by the govt. Plan benefits are the same carrier to carrier.
- MAPD: Plan benefits vary carrier to carrier, plan to plan. Plan benefits can change upon yearly renewal.
- Medigap: No prescription coverage. You must buy a standalone Part D prescription plan. You can change your Part D prescription plan yearly upton Annual Open Enrollment, Oct 15t to Dec 7th.
- MAPD: Prescription card is built into the health plan. You can’ not change the prescription card that comes with the health plan.
- Medigap: (Higher) There is a higher premium for the coverage and network access.
- MAPD: (Lower) Lower premium. Some carriers offer zero premium plans.
- Medigap: (Lower) Your out of pocket costs would be your Part B deductible and Part D prescriptions out of pocket costs at the pharmacy.
- MAPD: (Higher) Can be as high as $7,100 for In-Network services in addition to prescription costs at the pharmacy.
- Medigap: You can change your Medigap policy during the year if you are approved by medical underwriting. Part D prescription plans can be changed each year without medical questions. during Anuual Open Enrollment, Oct 15th thru Dec 7th.
- MAPD: You can change your MAPD every year during MA OEP (1/1 thru 3/31) with no medical questions asked. However, to move to a Medigap policy, medical questions are asked and the carrier can deny your request to enroll.