Welcome to Maple Valley Insurance Group. If you’re here, chances are you want straight answers on the difference between Original Medicare + Medigap and Medicare Advantage. We’ll walk you through both in plain English — no fluff, no jargon, just the facts that actually matter, whether you’re in Michigan, Florida, New Mexico, California, or anywhere in between.
Original Medicare + Medigap: The Classic Combo
Original Medicare includes Part A (hospital insurance) and Part B (outpatient care like doctor visits, lab work, and preventive services). You can add Part D for prescription drugs and a Medigap plan to cover the “gaps.”
Key Features:
- See any doctor who accepts Medicare — no networks
- Medicare pays 80% of covered costs, and Medigap can pay the remaining 20%
- No referrals needed, ever
- Stable and predictable costs
Most Popular Medigap Plans:
- Plan F: Full coverage (available only if eligible before Jan 1, 2020)
- Plan G: Pays everything except the small annual Part B deductible
- Plan N: Lower premiums with small copays for doctor visits
Need help choosing a Medigap plan that fits your budget and state? Call us at 269-244-3420 — we shop top-rated carriers in over 30 states.
Medicare Advantage (Part C): The Bundled Option
Medicare Advantage plans (Part C) are offered by private insurance companies. These plans replace Original Medicare and often include drug coverage plus extras like dental, vision, and hearing.
How It Works:
- You join a private plan that manages your care
- You may be limited to doctors and hospitals in a network
- Most plans include prescription drug coverage (MAPD)
- You may pay copays, coinsurance, and have out-of-pocket maximums
Pros:
- Lower monthly premiums (some as low as $0)
- Includes extra benefits like gym memberships, dental, vision, hearing
Cons:
- Restricted provider networks
- Prior authorizations may be required
- High out-of-pocket costs if you get sick — up to $8,850 annually in 2025
- Risk of denied treatments or limited access to top hospitals
Important Tip: If you live in a rural area or want access to specialty hospitals (like Mayo Clinic), make sure your doctors accept the plan.
Want help checking if your providers are in-network? Call 269-244-3420 — we’ll verify it for your location.
Medigap vs Medicare Advantage: Side-by-Side Comparison
| Feature | Original Medicare + Medigap | Medicare Advantage (Part C) |
|---|---|---|
| Doctor Choice | Any Medicare provider | In-network providers only |
| Referrals Required? | No | Often required |
| Predictable Costs | Yes | No — varies year to year |
| Drug Coverage | Add Part D | Usually included (MAPD) |
| Dental/Vision/Hearing | Not included (add DVH plan) | Often included |
| Out-of-Pocket Maximum | No limit (but Medigap protects) | Up to $8,850 (2025) |
| Travel Nationwide | Covered | May be restricted |
What About Prescription Drugs?
With Original Medicare, you’ll want to add a Part D drug plan. Use the Medicare Plan Finder at medicare.gov to compare plans based on your prescriptions.
Even if you’re not currently taking medications, having a plan protects you against sudden costs. Prescription drugs can run thousands of dollars per year.
When Can You Switch Plans?
- Medicare Advantage Open Enrollment (OEP): Jan 1–Mar 31
- Annual Election Period (AEP): Oct 15–Dec 7
- Medigap Open Enrollment: 6 months after Part B begins (no health questions!)
Thinking about switching to or from Medicare Advantage? Call now for help timing your move, wherever you live.
Bottom Line: What Should You Choose?
Choose Medicare Advantage if:
- You want the lowest upfront cost
- You’re okay with provider networks
- You don’t mind copays or referrals
- You like having dental/vision/hearing bundled in
Choose Original Medicare + Medigap if:
- You want maximum provider freedom
- You want predictable annual costs
- You have complex health needs or value top-tier access
We often recommend Original Medicare + Medigap to clients who want to protect their finances long-term and avoid nasty surprises with authorizations or medical bills.
Real Talk From Trusted Medicare Advisors
We’ve helped thousands of people across the country navigate their Medicare options — and we’re happy to help you, too.
📞 Call 269-244-3420 to speak directly with a licensed, independent Medicare agent who knows his or her stuff.
🎓 Get expert guidance, completely free. We’re paid by the insurer — not by you. No pressure. Just real help.
💬 Prefer a face-to-face meeting? If you’re in Michigan, we serve Kalamazoo, Portage, Vicksburg, Mattawan, and beyond. For others, we’re just a phone call or Zoom chat away. What have happy clients all around the USA!
Want to Learn More?
Check out these helpful resources:
- Best Medicare Supplement Plans
- What Are Medicare Part B Excess Charges?
- Plan G vs Plan N Comparison
- Dental, Vision & Hearing Options for Seniors
Medicare can be confusing. We make it simple.
Talk to a licensed, independent Medicare expert today. Call 269-244-3420.