What's your go-to strategy for helping someone decide between Medicare Advantage and Medigap?

Question

Craig Kirscht · Accepted Answer

To help someone choose between Medicare Advantage and Medigap, I ask:
Health Usage: Frequent doctor visits or chronic conditions? → Medigap.
Budget: Want low monthly premiums? → Medicare Advantage. Prefer predictable costs? → Medigap.
Doctor Choice & Travel: Want nationwide coverage and keep any doctor? → Medigap. Okay with networks? → Medicare Advantage.
Drug Coverage: Want it included? → Medicare Advantage. Don’t mind a separate plan? → Medigap.
Simplicity: Want one bundled plan? → Medicare Advantage. Don’t mind piecing it together? → Medigap.

It's important to have a conversation going over all of this and find out what fits best for each individual. There are lots of plans out there with different benefits. Not all may fit your needs.

Anthony Castelluccio · Answer

I really don't have a strategy to help someone decide Medicare Advantage vs Original Medicare. I always explain all of the details about both options. The 2 big differences are Medicare Advantage you should stay in network and if you have some chronic conditions then you could pay a lot more out of pocket then Original Medicare plus a supplement. Also if you are on a Medicare Advantage for more than 12 months you may not be able to qualify to get into a Medicare Supplemental plan. Many people i meet don't know that and are stuck paying a lot for their health care.

Answered by Anthony Castelluccio on April 12, 2025

Agent Licensed in PA, DE, MD, NJ & VA

Answered by Anthony Castelluccio Medicare Insurance Agent

Charise Karjala · Answer

I have a seven question algorythm that is 99% accurate.  Seven questions and the appropriate strategy is evident.

Tammera Marrs · Answer

Presenting both Medicare Advantage and Medicare Supplement options is how we help clients decide. Normally during our presentation the client has a definite decision before we are even done presenting. We feel education is the best option

Answered by Tammera Marrs on May 1, 2025

Broker Licensed in KS

Answered by Tammera Marrs Medicare Insurance Agent

Keaton Lewis · Answer

When explaining the differences between the two, I like to say the Medigap is the "prepay" option and Medicare Advantage is the "pay as you go" option. If a client knows they are going to have some serious health issues and lots of medical care, i would recommend the Medigap route. However if they are pretty healthy and especially if they are looking to save money, I usually recommend Medicare Advantage, so they can "pay as they go" instead of paying up front whether or not they need it.

Answered by Keaton Lewis on May 5, 2025

Broker Licensed in ID, AZ, CA & 11 other states

Answered by Keaton Lewis Medicare Insurance Agent

Aaron Solomon · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/whats-your-go-to-strategy-for-helping-someone-decide-between-medicare-advantage-and-medigap#aaron-solomon

Michael Yost · Answer

My strategy is to best explain both options to someone and let them decide what is best for them. Medicare is a very complicated system and people need to understand how their plan options work so they can make an informed decision.

Answered by Michael Yost on March 30, 2025

Broker Licensed in OH, AL, AZ & 27 other states

Answered by Michael Yost Medicare Insurance Agent

Rene Casanova · Answer

What is most important to the client such as the freedom to go to any doctor or hospital without having to make sure they are in a network or getting a referral to see a specialist, and their budget. If they can afford a Medigap policy and Part D prescription drug plan and want the freedom to choose any doctor they want to see the choice is an easy one.

Answered by Rene Casanova on April 3, 2025

Broker Licensed in TX

Answered by Rene Casanova Medicare Insurance Agent

Denise Berg · Answer

My strategy is to explain each and ask follow up questions like;

a) Do you travel within the US and do you reside in another state for 6 months?
b) Do you want the freedom to see any doctor?
c) How do you feel about copays?
d) Would you rather have one card to access your all of your benefits?
e) Would you prefer not to have a schedule for preventive services that limits exams?

Michael Braden · Answer

I like to ask the prospective client, what their understanding is of both Medicare ADvantage and Original Medicare with adding a Medicare Supplement/Medigap plan.

From there, I just speak with them about their travel plans, will they be staying in their local are primarily, or; do they anticipate traveling, that is when I reiterate the differences with the plans.

Often times Medicare Advantage plans can bea good fit, if the prospect needs/desires the extra benefits taht come with the plans, but they are restrictive.  Then, I draw their attention to the MOOP, that comes with each MA plan,  Explaining that there often times, the MOOP can be 2-4 times more in poteeential out of pocket costs than having Original Medicare with a Supplement.

Lastly, I urge them to spend  time reading teh Explanation of Benefits section of any MA Plan they are considering, so they have a firm understanding of the benefits, and how   they work,

Jennifer Stark · Answer

My go to strategy is to show the difference between the 2 plans. making sure the client understands how they differ in each coverage. Then helping them break down what their personal needs are, and answering all questions they have. From there they can decide what works best for the healthcare needs.

Answered by Jennifer Stark on April 21, 2025

Broker Licensed in WI, CO & FL

Answered by Jennifer Stark Medicare Insurance Agent

Danielle Moody · Answer

I like to do a thorough needs assessment and go over all options with my clients to determine which plan options are best for their situation. Sometimes, depending on income, travel, and other factors, it makes a big difference.

Answered by Danielle Moody on April 16, 2025

Broker Licensed in FL, AK, AL & 48 other states

Answered by Danielle Moody Medicare Insurance Agent

DeeDee England · Answer

My strategy for helping someone decide between Medicare Advantage and Medigap would be to first go over how Medicare works. Then I would explain how each of these options works with Original Medicare. I would show them all the options for each of these with the companies available in their area as well as the costs involved.

Answered by DeeDee England on April 22, 2025

Broker Licensed in IA & NE

Answered by DeeDee England Medicare Insurance Agent

What's your go-to strategy for helping someone decide between Medicare Advantage and Medigap?

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What's your go-to strategy for helping someone decide between Medicare Advantage and Medigap?

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