Medicare Supplement (Medigap) plans are part of the Medicare program and sold by Medicare-approved private insurers. Medigap is not meant to be a standalone health plan. Instead, it covers the out-of-pocket costs from Medicare Parts A and B, such as copayments, coinsurance, and deductibles. There are ten standardized Medigap plans available in most states, lettered from Plan A to N.
On the other hand, Medicare Advantage (Part C) is a set of plans offered by Medicare-approved private insurers. Medicare Advantage covers Part A and Part B benefits but can also provide extra benefits such as prescription drug coverage, and routine dental, vision, or hearing services. To enroll in Medicare Advantage, you must first be enrolled in Original Medicare.
Can You Have Medigap and Medicare Advantage Together?
You cannot have Medigap and Medicare Advantage at the same time. Private insurers cannot offer Part C coverage if you are currently enrolled in a Medicare Supplement, as it would be illegal to do so. It is an either-or situation when it comes to Medigap and Medicare Advantage plans. Once you are enrolled in Original Medicare, you can choose to add on a Medigap plan or join a Medicare Advantage plan. Medigap plans were only designed to supplement Original Medicare, whereas Medicare Advantage is more of an alternative to Original Medicare.
What Are The Exceptions?
You may have both Medicare Advantage and Medicare Supplements briefly in some situations. For example, if you are in a transition from a Medicare Supplement plan to Medicare Advantage or from Medicare Advantage to Medigap, you may have both plans temporarily.
If you’re enrolled in Medicare Advantage, and you later decide to drop the plan in favor of Original Medicare, you can purchase Medigap if:
- You enrolled in the Part C plan when you were first eligible for Medicare, i.e., during your Initial Enrollment Period.
- It is your first year of having the Part C plan. This is known as the trial right.
Suppose you were enrolled in Medigap, and you decide to drop your coverage and enroll in a Medicare Advantage plan for the first time. In that case, you may also have both plans briefly during the transition.
You can apply for a Medigap plan beginning from 60 days before your Part C coverage stops. If you drop your Part C plan in favor of Original Medicare and try to enroll in your former Medigap plan, you may not be able to do so unless you have a guaranteed issue right or a trial right. Apart from these cases, you cannot purchase a Medicare Advantage plan while you have a Medigap plan.