If Medicare Supplement (Medigap) plans are better for long-term coverage, why don't more people choose them?
Answered by 65 licensed agents
Question: If Medicare Supplement Medigap plans are better for long-term coverage, why don't more people choose them? What I see in my practice here at State Farm on Kelly Street, and I've been doing Medicare planning now for the last decade, is that people don't understand the differences between Medicare Supplement Medigap and Medicare Advantage. Of course, Medicare Advantage gets all the commercials, all the hype, and stuff in your mailbox.
What we do here is explain to our clients both the advantages and disadvantages of Medicare Supplement and Medicare Advantage. Whatever makes better sense for the client, we help them with that. So, work with someone who can offer you both Medicare Supplement and Medicare Advantage. More importantly, work with someone who's dealt with it for years and knows the good and bad about both plans. We would love to help you. Please, these decisions are way too important to take by chance or wait until the last minute. Let us help you. We'd be glad to.
Question: If Medicare Supplement Medigap plans are better for long-term coverage, why don't more people choose them? What I see in my practice here at State Farm on Kelly Street, and I've been doing Medicare planning now for the last decade, is that people don't understand the differences between Medicare Supplement Medigap and Medicare Advantage. Of course, Medicare Advantage gets all the commercials, all the hype, and stuff in your mailbox.
What we do here is explain to our clients both the advantages and disadvantages of both Medicare Supplement and Medicare Advantage. Whatever makes better sense for the client, we help them with that. So, work with someone who can offer you both Medicare Supplement and Medicare Advantage. More importantly, work with someone who's dealt with it for years and knows the good and bad about both plans. We would love to help you. Please, these decisions are way too important to take by chance or wait till the last minute. Let us help you; we'd be glad to.
Advertising often misleads people to assume they know things they don't. The privatized companies that offer MA plans televise 9500 commercials per day! Have you seen many, if any, commercials regarding supplement plans? So many people don't have the information about them and the difference they make. In today's world, many seniors fear that they will be "Taken for a ride", so trusting a company or an agent is difficult.
MA companies make it seem so easy! They lay out the positives, but don't show what is missing from the policies, such as the choice of practitioners, specialists, or travel benefits. It doesn't show that the highest quality choices very often do not accept the MA product. It doesn't show what Out-of-Pocket costs are if you do not choose a Network Provider. It doesn't clarify that in giving your Original Medicare back for the MA plan that you lose coverage for your Durable Medical Equipment needs. Those plans need to be changed every year, and the policy you have today may not be in place next year, or your Doctor may not even participate in that plan any longer. You rarely have that issue with Medigap plans.
And we cannot leave out that the premiums for the Medigap plans may be out of reach for some. Unfortunately, some find out too late that they chose "Easy" instead of "Thorough", and what they saved in premiums cost them hugely later on when they needed more quality coverage.
I think it's because premiums go up every year and become pricy. To get another med sup at a lower rate, one has to qualify for that and sometimes they cannot. It doesn't come with dental, vision and hearing nor a prescription drug card. You have Medicare Part B premiums on top of that and it's gotten higher over the years. I remember when Part B was $99.00.
Medicare supplement plans are generally much lower cost for people age 65 - to - 70 but after that, things change. I have customers who started paying $ 125 monthly for their supplements but their plans closed for new business and increased premiums on current grandfathered members to $ 500 monthly (and higher).
In my opinion, more people are choosing them because there’s less red tape about what is covered versus going with an advantage plan. As an agent of 20 years for Medicare plans, I offer both advantage plans and supplements. And I am clear about the fact that both are offered and give the opportunity for a client to choose one or the other Many people like a zero premium plan such as with an advantage plan.
Medicare Suppliments are good in that they are able to provide additional coverage for Medicare Part A hospital coverage and Medicare Part B doctor coverage to minimize out of pocket expenses to just $257.00 for the Part B deductible. But they do so at a price, as policies for a G plan average between $240 to $260 per month. This is in addition to paying for the Medicare Part B monthly premiums of $185.00 per month, a monthly fee for a Part D prescription drug plan and an average cost of $60 to $75 per month for a dental plan. These monthly costs do add up and can put these kind of plans out of reach for those with fixed budgets. Advantage plans on the other hand, can start as low as zero premium, vision, dental coverage for a lower monthly fee. The trade off? You may have to pay more out of pocket for a big health event, as max out-of-pocket costs can be up to $6000 or more annually.
It is a choice. Some may want the security of the Medicare Supplement over the possible lower cost of the MAPD. The MAPD has no underwriting, whereas the MS plans do. If you have health issues that prevent you from lowering your monthly premiums, then you can choose the alternative of the MAPD plans.
Many people don’t choose Medicare Supplement (Medigap) plans because they often have higher monthly premiums, and the costs are more predictable but paid upfront. Others prefer Medicare Advantage plans because they bundle extra benefits like dental or vision and may have lower premiums, even though the long-term costs can vary—so the choice often comes down to budget, health needs, and personal preference.
Medicare plans are not a one size fits all meaning Medigap plans aren't always the best option for everyone. It depends on many factors. Monthly Cost is typically the reason many people won't choose a Medicare Supplement or end up switching to a Medicare Advantage.
Most people don’t choose a Medicare supplement because they look at the monthly cost. You’ve got $120 plus supplement premium and a separate part D drug plan. That upfront expense scares people off, even though it usually saves money and stress later.
Usually people that don’t choose Supplements is because they have a monthly premium and you have have to buy drug plan and vision dental separately. Where with a Medicare Advantage there are usually no premiums and other things are included.
A number of factors can affect an individual's decision regarding the type of coverage they choose. People that have both Medicare and Medicaid often do not need secondary coverage. Others, who are very healthy at the time of turning 65 elect to go with Medicare Advantage due to it's low premiums and extra benefits. Another group that chooses Medicare Advantage are those that did not elect Medigap at 65 and are not eligible through medical underwriting and need coverage with an out-of-pocket max (as Medicare A & B do not have one).
A lot of people can’t afford the additional expense of a Medicare Supplement plan. Plus, you are required to get an additional prescription drug plan and supplemental dental and vision. A Medicare advantage plan sometimes seems simpler for a lot of people. It is important to work with an insurance advisor that can look at all the different options and decide the best option for you.
Affordability is the number one concern. Due to our global economy, these factors are the key. Since we currently live in a state of flux, folks are dismissing our future & prefer to put off the inevitable. One of the main statistics that I have been aware of for years is that 2 out of every 3 seniors will experience a visit to a long-term care facility in their lifetime. This is not a cheap out of pocket cost! Another common problem is that folks believe that they are in great health. But what about being in a car accident? With that situation, your health is no longer good & now you are greatly impacted.
Generally the premiums. Medicare Beneficiaries weigh the premiums for Medicare Supplement Insurance versus Medicare Advantage. An increasing percentage are choosing enrollment in Medicare Advantage.
Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Well sometimes it isn't always the best plan for the client. The Supplement plans are expensive, and they do not include dental and vision. Most Advantage plans include some dental and vision and are cheaper in cost. These two things are important to seniors as they get older. Saving money for retirement, and getting their teeth checked every year is a way to stay healthy. The key question to ask is how much can you afford? And let them give me a budget. Then see if the Supplement (Medigap) is the right fit.
They only look at Dollar signs and not the big picture. Also, Medicare Advantage salespeople are more interested in the fact that most Advantage plans pay a lot more commission than Medigap plans. So- not always in the best interest of the consumer, but in the best interest of the salesperson.
First, there’s going to be a premium for a MedSupp plan on top of your part B premium. I have many clients on a tight income and they can’t afford another $200+ per month for a supplement. There are alternatives like high deductible plans that have lower premiums, but many people feel that if they have a high deductible plan, they may as well get a Medicare Advantage plan, which, while it has copays, coinsurances, and provider networks, in many cases does not have a monthly premium.
Second, MedSupps require a separate Prescription Drug plan. In some cases, there are $0 premium plans available, but increasingly the PD standalone plans have premiums as well, so now you’ll have Medicare Part B, your MedSupp premium AND your part D plan premium. Most Medicare Advantage plans include Part D coverage, often at no additional premium.
Third, MedSupps do not provide dental, vision, or hearing coverage, so there are MORE premiums to add to the list. Most Medicare advantage plans include some level of DVH coverage.
Because of this, many brokers are reluctant to pitch a MedSupp. I personally will always ensure people, especially those new to Medicare, know their options so they can make an informed decision about their coverage that most fits their needs from a healthcare and budget perspective.
Better is a very subjective term. I find when a client is educated on both Advantage plans & Supplement plans. They choose what fits their needs the best from the very start of Medicare.
One of the main reasons can be the costs associated. You still have to pay your Part B premium, you would likely need to enroll in a Prescription Drug Plan and it would good to have a Dental Vision and Hearing plans as well.
You do have more freedom, go to any physician, DDS, etc. that accepts Medicare.
Another consideration is that to get the best rate one needs to usually register during the open enrollment period to avoid underwriting.
This generally comes down to affordability. A Medigap plan has a monthly premium where in general, most Advantage plans do not so that is usually the number 1 reason people choose Advantage over Medigap. Medigap plans are fantastic coverage, but the premium increases every year and sometimes twice a year.
The second part is that it can only supplement your A & B. Nothing more, nothing less. So you are still required to get another policy for your Part D (Drug coverage). Which adds more cost on the monthly premium side.
Advantage plans are more of a bundled structure so you have medical, dental, vision, hearing and drug coverage (in most cases) all in one plan without a monthly premium (in most cases). But there are copays as you use the coverage so each structure has it's pros and cons.
My opinion is because the premiums can be costly and continue to go up i think individuals should do a thorough investigation or talk to you agent thanks
Many people are enticed by the low premiums for the Advantage plan and additional benefits like fitness, dental, vision, over-the-counter, etc. They view their health in today's terms not in future terms when potentially health changes occur. So, it's about the cost and coverage. People also think that they can enroll in a Medigap down the road but find out that guarantee issue rights are not available and cannot medically qualify. They forget that after the initial enrollment, the insurance company requires the applications to go through medical underwriting. Not everyone qualifies and pre-existing do count in the overall evaluation.
Most Medicare Beneficiaries are not properly educated, for many reasons, on what choices they have based on where they live (zip code/county). They often listen to friends, family, etc. and what they have and think it will be the same for them. Everyone is different and need to be treated as such by an experienced licensed agent. Other times it's because they can't afford the Medigap policy as time goes on. They are health insurance plans and will increase over time unfortunately but if you live in a "birthday rule" state, you can shop those premiums based on that states rules.
When I am given the privilege to assist someone who is aging in, turning 65 and who also plan to trigger their Medicare Parts A and B, my primary objective is to make certain that I assist that person to gain a complete and solid grasp of their options, such as Traditional Medicare A and B only, or Traditional A and B along with a Medigap (aka Medicare Supplement Plan), what about Part D Drug coverage, or no Traditional A and B, but a Plan C (aka Medicare Advantage Plan) and or to understand of any potential penalties. Within my Agency it has been my experience when Folks have a good understanding of their options, their costs and or financial risks over half of my Clients chose Medicare Supplements and Part D Drug Plans alongside Traditional Medicare A and B, that approach costs more monthly, but no uncertainty whatsoever as to what You will be responsible to pay, Awesome Peace of Mind.
Medicare plans are not a "one size fits all" and people who choose Medicare Advantage plans do so for the bundled services (prescriptions, dental, vision, hearing) and little to no monthly premiums. People who choose Medicare Supplement plans are willing to pay monthly premiums for the freedom to see any doctor who takes Medicare without verifying networks. They are willing to purchase stand-alone plans for dental and vision. It comes down to personal preference; people on both types of plans get the care they need.
Medigap are the majority of plan selections. However, insurance companies spend more advertising dollars on medicare advantage plans, because the insurance company makes more profit from those. Also, low income people like the zero dollar monthly premium, but pay 5-10K per year, in max out of pocket should they become seriously ill.
Medigap is the better choice. I recommend Plan N for the majority of people. Most cost effective medigap plan.
Medigap is less popular mainly because it costs more each month and doesn’t include extras like dental, vision, or prescriptions. Many people choose Medicare Advantage instead because it has a lower upfront cost and added benefits, even though it comes with more out-of-pocket costs when you use care.
Who says that Medigap pans are better for long-term coverage? There is no "1-size fits all" for Medicare plans. The choice between a Medigap plan and an Advantage plans depends on a number of factors, including: state and county where you live, Dr's you want to be able to see, money you have available. It's not a good idea to base such an important decision on reading generalized articles you find online that do not reflect those factors. It's important to use a local and experienced agent!
That’s a really insightful question — Medigap plans do provide strong long‑term coverage, but there are several reasons why not everyone chooses them. It often comes down to cost, eligibility, and alternatives.
The coverage a beneficiary choses is a personal choice. Medsup plans have a cost that some people can't afford. Medicare Advantage plans offer more comprehensive coverage including dental, vision, hearing etc.
Medsups are like having car insurance. You pay a monthly premium and hope you don't need it. Medicare Advantage is more like pay as you need it.
Medicare supplements actually do not cover long term care, they do cover skilled nursing when a client has been in the hospital for 4 days and 3 nights and has been prescribed by a doctor, at which point Medicare will cover the first 20 days of care. Days 21-100 normally costs the client 209.50 a day while medicare covers the rest. If more time is needed, back in 1998 congress passed a law stating that medicare is no longer allowed to cover home care, assisted living or nursing home after day 100. The client needs to find different covered for that, WHILE they are healthy.
I have been in the Insurance industry for 25 years. In 2006, when Part C & D were introduced, many consumers enrolled in Part C. Today, more than 50% of retirees on Medicare select Part C. To explain, Part C has grown over the past 19 years due to $0 premium plans, ancillary benefits and decreased medical underwriting requirements. The downside is managed care, high Maximum Out of Pocket (MOOP) costs, trends where ancillary benefits are being reduced and many Part C plans are leaving in 2026.
Medicare Supplement plans (Medigap) have a higher premium and will increase in premium as you age. However, medical costs are more predictable and you are not subject to the Annual Enrollment Period (AEP) which runs from October 7 - December 15th of each year.
You need an educated insurance broker to guide you through your options as you make these important choices. Call me, I will be happy to assist you! Thanks!
Traditional Medicare is the bases for all plans (Medicare Supplement and Medicare Advantages) and when it comes to long-term care it is covered from a short-term perspective meeting eligibility criteria.
It's not universally the better option but in summary it usually comes down to cost. If you are short sighted about finances, you may focus on the monthly premium instead of the financial exposure.
For some, affordability may be a concern. Others may choose to enroll in a Medicare Advantage plan, thereby not needing the Medigap plan (you cannot have both.) Or, they may have not been effectively guided by a licensed agent to know the benefits of the Medigap plans.
Medicare Supplement plans come with a monthly premium and sometimes that premium just does not fit the budget. Other people may feel like they’re healthy enough to not need all the coverage provided from a Medicare Supplement plan. The caveat with this line of thinking is that those people will likely miss their guaranteed issue period to get on a supplement with Hoyt going through underwriting.
Long-term care (LTC) plans aren’t healthcare insurance. MediGAP is healthcare insurance plans. LTC plans helps cover chronic or disabilities such as bathing; dressing. It is different from healthcare plans
Medigap plans have a premium that increases every year on the policy anniversary date. There are deductibles to meet as well as a prescription premium and prescription co-pays. It depends on if you can afford the medigap plan. Everyone's situation is different.
First, one has to define “better”. What is “better”?
• No networks.
• Less prior authorizations.
• More financial protection if something serious happens.
• Standardized...A Plan G is a Plan G no matter where you live. They don’t change from year-to-year.
After that, the main reasons why more people don’t choose them are as follows:
1. The 800# TV ads from the corrupt, publicly traded e-brokers. The ads and agents that represent these companies do not give full disclosure about ALL the options and pros and cons of each option that a Medicare beneficiary has. Unfortunately many people that have enrolled into Medicare Advantage over the last 5 years or so have little to no clue what they have and the pros and cons that go along with it.
2. Almost 20% of Medicare beneficiaries also receive Medicaid, therefore they have no need for a Medicare Supplement.
3. Many people can’t afford the escalating premiums. For those that can’t, they need to seriously consider a High-Deductible Plan G. It is “The Best Alternative To Medicare Advantage.”
4. Then you have a large percentage of Medicare beneficiaries that have group retiree coverage in place of or in addition to their regular Medicare. These would include those who have retired from federal, state, and local government, as well as those in the military that have Tricare for Life.
5. Lastly, there are people that have truly weighed their options and prefer Medicare Advantage over a Medicare Supplement because of the $0 to low premiums and the extra benefits (dental, vision, etc.). And they are willing to deal with copays, networks, and annual changes. From my experience and research, the vast majority of people that have a Medicare Advantage plan are satisfied to very satisfied with their plans.
So, “better" depends on each Medicare beneficiary's specific needs, philosophy, and budget.
Medicare Supplement/Medigap is a good option to support your Medicare coverage. Every individuals needs are different and may require a different solution. Meeting with a licensed Medicare Agent and discussing your needs will help you get the best solution for your healthcare.
Each person has different needs and some people prefer a Medigap policy so they are not restricted on what doctors they see. A Medigap policy allows you to see any doctor that accepts Medicare. For some individuals this is important and they elect to have a Medigap policy. There is also premium involved with Medigap policies where as most MedicareAdvantage plans have $0 to low premiums. Cost is a factor for most people when evaluating plans.
Medigap has a monthly premium and it built à la carte in terms of total coverage needed: dental, vision, hearing and part D so with all of these separate changes some people feel it is easier to just bring them all together- like in an Advantage plan. The calculations of Medigap balance out when considering the out of pocket expenses and deductibles of the other coverages. This just means you pay now or pay later- but may be easier to use Medigap if you are using multiple providers.
Generally, people are short-sighted. At 65, life is good, and they feel they are healthy, and the monthly cost of -0- is very appealing. As time goes on, the node starts falling, the deductible starts building, and they are not able to qualify. With Medigap carriers so they must stay with an Advantage plan.
Medigap plans typically have higher premiums and can involve health question underwriting if you miss the initial enrollment window. People tend to choose the Medicare Advantage plan because of lower cost and the extra benefits.
Depending on your unique needs,the broker will help determine the best plan for an individual. Each will client require a different type of coverage, depending on medication and doctors.
Medicare Supplements have a premium and some people can't afford them. Those premiums will also go up over time so they need to understand they're paying for their coverage. A lot of people who are new to Medicare may not use their coverage enough to see the benefit to the larger premium, but they need to understand that statistically, they will eventually use that coverage and the premium will be worth it!
That is a very good question! The truth is, while Medicare Supplement gives you incredible financial predictability down the road, it requires you to pay a premium right now, whether you see the doctor or not. And those that select a Medicare Advantage plan normally go that route because they simply cannot afford the monthly premium. On top of that, standard Supplements don't include routine dental, vision, or prescription drugs, so people choose Advantage plans to get everything wrapped up into one affordable package. As your partner, I don't believe one is universally 'better'. The best plan is the one that fits your health needs today without hurting your family's wallet tomorrow.
I think there is various different reasons why more people don’t pick medigap policies. I would say a lot of people aren’t going with Medigap plans because of premium costs. There is also a lot of added value in the Medicare advantage plans with dental, vision, over the counter allowances, and fitness programs for free that people don’t want to miss out on as well.
The answer to your question is a bit nuanced. Each plan offers different elements, and they also differ among the plans. Much of the choice has to do with personal needs and preferences, and even sometimes your location.
The choices are broad and can be a little complex. It all comes back to your personal preferences, your preferred medical practitioners, your required services, your preferred pharmacy, and the medications you are prescribed, and of course, your budget. One plan is comprehensive (Advantage) and the other (Supp) is more a la carte.
Another factor is the changing environment. The Medicare system is constantly making changes to be aware of.
Medicare plans are not "one size fits all". People choose other options for many different reasons. The most common reason I find is budget. Also, some people like the all-in-one convenience that a Medicare Advantage plan provides. There are advantages to both options, and that is why it is essential to learn about each plan so that you can decide what is best for you.
Simple answer: COST. But that is somewhat of a shortsighted view. This is how I explained it to my Mom, who chose a Medicare Advantage plan before I was licensed in her state. She chose a Medicare Advantage with a $4800 Out-of-pocket max. Well, after a few years she needed to have some surgery. There were a bit of complications and she spent 3 or 4 extra days in the hopsital. she need to come up with $4800 for her portion. Well, 4 years later she needed the same surgery. Different spot, same surgery, and the likelihood of her needing some extra days, because of diabetes, was high. So if we take that $4800 divided by 4 years - she was paying an extra $100 a month for that "free" Medicare Advantage plan than she thinks she was.
There are many reasons folks don't choose a supplement. Some people want dental, vision, and hearing benefits, which are often included in Medicare Advantage plans, as well as Prescription
coverage. Cost as far as monthly premiums for a Medicare Supplement are also a concern for
