What's The Difference?
Medigap vs MAPD?
- Medicare Supplements are known as "Medigap plans".
- Medicare Advantage Health plans - MAPD's also referred to as "Medicare Part C".
Provider & Hospital Networks:
- Supplements: Nationwide coverage.
All hospitals and ~95% of providers in America accept medigap plans.
- MAPD provider networks vary carrier to carrier, plan to plan. Can be limited to NJ access or regional access. Out-of-state access may not be available.
- Supplements: Plan benefits are standardized by the government. Plan benefits and the provider networks are exactly the same, carrier to carrier. Plan G is the same at any carrier.
- MAPD: Plan benefits vary carrier to carrier, plan to plan. Plan benefits as well as proivder networks can change upon annual renewal. Plans can be terminated or discontinue upon annual renewal.
- Supplements do not include prescription. You would buy a Medicare Part D prescription plan from one of the private
carriers. Part A & B.... Supplement &Part D.
- MAPD: Medicare helath plans have prescription coverage "built into" the health plan. If your prescriptions change or are no longer covered, you have to change your entire Medicare health plan up Annual Open Enrollment. You can't just change the prescription like you can with Supplement + Part D.
- Supplements: (Higher) - There is usually a higher monthly premium. $100-$150/month
- MAPD: (Lower) - Premiums can be lower. Some carriers offer zero premium plans.
Out Of Pocket Expeneses:
- Supplements: (Lower) $233 deductible then Medicare A & B is covered at 100%.
- MAPD: (Higher) OOP expenses include: copays, coinsurance, deductibles.
Your annual max out of pocket can be as high as $7,100 for In-network services.
- Supplements: Once you enroll in a medicare supplement is difficult to change to another medicare supplment plan.
Medical underwriting is required
Part D prescription plans can be changed each year during Anuual Open Enrollment, Oct 15th thru Dec 7th. When you see Joe Namath on TV, that's when you can shop Part D.
- MAPD: You can shop/change your Medicare health plan every year during Annual Open Enrollment Oct 15th thru Dec 7th. When you see Joe, you can shop your MAPD.