Medicare Advantage vs. Medicare Supplement: How to Tell Which Plan You Have
The fastest way to tell Medicare Advantage from a Medicare Supplement is the card you hand the doctor’s office. If you show one insurance company card instead of your red, white, and blue Medicare card, you most likely have Medicare Advantage. If you show your Medicare card plus a second insurance card, you most likely have a Medicare Supplement.
Plenty of people aren’t sure, especially if a family member helped them sign up years ago. Knowing which one you have changes what you can do next.
How Do I Know If I Have Medicare Advantage or a Medicare Supplement?
Two or three of these checks usually settle it.
1. Which card do you show at the doctor?
If you’re in a Medicare Advantage plan, you use your plan’s card to get services, not your Medicare card. With Original Medicare, you show your Medicare card, and if you have supplemental coverage you carry that card too.
So one card from an insurance company usually means Medicare Advantage. Two cards (Medicare plus a supplement) usually means a Medicare Supplement.
2. What does the card say?
Insurance cards vary, but the wording often gives it away:
- Medicare Advantage cards often say “Medicare Advantage,” or list a plan type like HMO or PPO. Many also show pharmacy information because the drug coverage is built in.
- Medicare Supplement cards often say “Medicare Supplement” and show a plan letter, such as Plan G or Plan N.
3. What shows up in your mailbox?
With Original Medicare, Medicare sends you a Medicare Summary Notice listing the Part A and Part B services you received. If you’re in a Medicare Advantage plan, your plan sends an Explanation of Benefits for your doctor and hospital visits instead.
Keep one thing in mind: stand-alone drug plans send Explanations of Benefits too. An EOB that only lists prescriptions doesn’t mean you have Medicare Advantage.
4. Where does your prescription coverage come from?
Most Medicare Advantage plans include Part D drug coverage. Medigap policies sold after 2005 don’t include prescription drug coverage, so people with a supplement usually carry a separate drug plan card.
Drugs on the same card as your doctor visits points to Medicare Advantage.
5. Have you been told to stay in a network?
If your plan has asked you to use in-network doctors, or to get a referral before seeing a specialist, that’s typical of Medicare Advantage. With Original Medicare and a supplement, you can use any doctor or hospital in the U.S. that takes Medicare.
Still not sure?
Log in to your account at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) and ask what coverage you have on file. Or call us at (386) 222-3030 with your cards in hand, and we’ll help you figure out what you have. There’s no charge for that.
What Is the Difference Between Medicare Advantage and a Medicare Supplement?
Both are sold by private insurance companies and both work with Medicare, in opposite ways.
A Medicare Advantage plan (Part C) replaces how you get your Original Medicare benefits. The plan handles your hospital and doctor coverage, usually adds drug coverage, and may add extras. Our Medicare Advantage plans page has more.
A Medicare Supplement (Medigap) sits on top of Original Medicare and helps pay your share of the costs Medicare leaves behind. See how Medicare Supplement insurance works with us.
Here’s how they compare, based on Medicare’s side-by-side of Original Medicare and Medicare Advantage:
| Medicare Advantage | Original Medicare + Medicare Supplement | |
|---|---|---|
| Which card you use | Your plan’s card | Medicare card plus supplement card |
| Doctors and hospitals | Usually the plan’s network | Any provider in the U.S. that takes Medicare |
| Specialist referrals | May be required | Usually not required |
| Yearly out-of-pocket limit | Yes, for covered services | Original Medicare alone has none; a supplement helps pay your share |
| Prescription drugs | Usually included | Separate Part D plan |
| Extra benefits | Some plans offer extras | Not part of a supplement |
| Part B premium | You still pay it | You still pay it |
Can You Have Both Medicare Advantage and a Medicare Supplement?
No. A supplement only works with Original Medicare, and Medicare says you can’t use one to cover Medicare Advantage costs. It’s also illegal for anyone to sell you a Medigap policy while you’re in a Medicare Advantage plan, unless you’re switching back to Original Medicare.
That’s the real reason to know which plan you have. If you find two insurance premiums leaving your account each month, one for a supplement and one for a Medicare Advantage plan, the supplement isn’t paying anything toward that coverage. Call us and we’ll help you sort out what’s active.
Which One Is Right for You?
Medicare Advantage is a good product for the right person, and so is a Medicare Supplement. The better fit depends on your doctors, your prescriptions, your health, and how you live. A few things we look at:
- Your doctors. If your specialists are in a Medicare Advantage plan’s network, that plan may work well. If they aren’t, a supplement keeps them available.
- Where you spend your time. Medicare Advantage networks and service areas can be tricky if you split the year between Florida and another state. A supplement goes wherever Medicare is accepted in the U.S.
- Your health outlook. People managing ongoing conditions often want predictable coverage with any provider. Others prefer an all-in-one plan with drug coverage and extras built in.
There’s no single answer on cost either. Costs depend on the plan, your county, and how much care you use, so we look at your actual situation. The same goes for the other senior insurance products people ask us about.
Can You Switch From Medicare Advantage to a Medicare Supplement?
Outside certain protected situations, Medicare notes there’s no federal guarantee an insurance company will sell you a supplement, and a policy may cost more because of past or present health problems.
We explain more about that in whether you can buy a Medicare Supplement at any time.
Some situations do give you a guaranteed right to buy one:
- Trial right. If you joined Medicare Advantage when you were first eligible at 65 and switch back to Original Medicare within the first year, you can buy certain supplement policies.
- First-time Medicare Advantage members. If you dropped a supplement to try Medicare Advantage for the first time, you generally have 12 months to go back.
- Your plan leaves. If your Medicare Advantage plan leaves Medicare or stops serving your area, or you move out of its service area, you get a guaranteed issue right. You have 63 days after that coverage ends to apply, and you keep the right only if you return to Original Medicare.
Keep any letters from your plan, since you may need them to prove you qualify. Changing from one Medicare Advantage plan to another usually happens during Annual Enrollment, October 15 to December 7. Before you drop anything, talk to someone, because the order you do things in matters.
Frequently Asked Questions
How can I tell what type of Medicare I have?
Look at the card you show the doctor. One card from an insurance company usually means Medicare Advantage. Your red, white, and blue Medicare card plus a second card usually means Original Medicare with a Medicare Supplement. You can also check your Medicare.gov account or call 1-800-MEDICARE.
Is Medicare Advantage the same as a Medicare Supplement?
No. Medicare Advantage replaces how you receive your Original Medicare benefits through a private plan, usually with a network. A Medicare Supplement works with Original Medicare and helps pay the deductibles and coinsurance Medicare doesn’t cover.
Do I need a Medicare Supplement if I have Medicare Advantage?
No, and you can’t use one with it. A supplement only pays costs under Original Medicare, and it’s illegal for anyone to sell you one while you’re in a Medicare Advantage plan unless you’re switching back to Original Medicare.
Do I need my Medicare card if I have Medicare Advantage?
You use your plan’s card for most care, but keep your Medicare card somewhere safe. Medicare says you’ll need it if you switch plans or go back to Original Medicare later.
Why do some seniors choose Medigap over Medicare Advantage?
Many want to see any provider in the U.S. that takes Medicare without referrals, which matters to people who travel or see several specialists. Others choose Medicare Advantage for built-in drug coverage and extras.
Bring Your Cards In
If you’re not sure what you have, or you want to know if it’s still the right fit, sit down with a licensed agent who compares plans from multiple carriers. Working with us is free to you, because the insurance carriers pay us.
We’ve served Lake City, Live Oak, Lake Butler, Jasper, Branford, High Springs, Gainesville, and the surrounding North Central Florida counties since 2013. Call (386) 222-3030, email info@seniorha.com, visit 763 SW Main Blvd. in Lake City, or contact us online.
