Right now in Michigan, many Medigap beneficiaries are facing an increase in their premiums

You have options. You can choose the health coverage that's best for you.

Medicare Advantage or Medigap?

Two plan choices will cover what Original Medicare (Parts A and B) does not.

  1. Medicare Advantage
  2. Medigap

Both:

  • Are offered by private insurance companies
  • Have a monthly premium in addition to your Part B premium (although some Medicare Advantage plans have a $0 premium)
  • Help cover the 20% of costs not covered by Original Medicare

So what's the difference?

Medigap plans

Medicare Advantage plans

  • Work side-by-side with Original Medicare and helps pay deductibles, coinsurance or copayments that Original Medicare doesn’t cover
  • Allow you to go to any doctor that participates with Medicare
  • Doesn't usually include prescription drug coverage, so you'll need to purchase a Part D plan separately
  • Offer everything Original Medicare does, plus more
  • Offer a network of doctors, but some also offer out-of-network coverage
  • Often includes prescription drug coverage and other extras like dental coverage and gym memberships
  • Tend to have lower monthly premiums

Learn more about the differences between Medicare Advantage and Medigap with our Medicare Explained video series.

Choosing a plan based on my health care needs

Medigap

Medicare Advantage

  • If you use more health care services (doctor visits, tests, surgeries, etc.) a Medigap plan may be the better option. 
  • Depending on the plan, you may pay more in monthly premiums, but less when you use services.
  • These plans don't have a maximum out-of-pocket limit, so you could end up paying more than if you had a plan with a capped limit.
  • If you go to a doctor often or have multiple tests or surgeries, a Medicare Advantage plan may be the better option.
  • Depending on the plan, you pay less in monthly premiums in exchange for a copayment or coinsurance when getting care.
  • With these plans there's a maximum out-of-pocket limit you pay, after which the plan takes over 100%.

Amount of savings

Medigap

Medicare Advantage

Generally have higher monthly premiums and low or no costs when seeking services. 

Example: The monthly premium on Plan F starts at over $100 and can go up to nearly $500. And since Medigap plans don't cover prescription drugs, you'll also need a separate Part D plan, which usually have a monthly premium as well.
You'll usually pay less in monthly premiums with a Medicare Advantage plan than Medigap. Premiums start as low as $0 per month and can go up to $200. These plans have a maximum out of pocket amount, meaning you know how much you could end up paying per year.

View prices for Priority Health Medicare Advantage plans.

If you travel often or spend more than six months away from Michigan

Medigap

Medicare Advantage

You get the flexibility to see any provider who accepts Medicare throughout the United States. All plans include coverage for emergency and urgent care, including a hospital stay, no matter where you are in the United States.

If extras are important to you

Medigap

Medicare Advantage

Usually don't offer any extra support tools. Offer extras to their members, such as gym memberships and care managers.

See what plan works best for you:

Compare plans

Or call one of our Medicare Experts at 877.211.2232 from 8 a.m. to 8 p.m., seven days a week. TTY users should call 711.

You can also visit medicare.gov to see plans available near you.

NOTE: Out-of-network/non-contracted providers are under no obligation to treat Priority Health Medicare members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.