Medicare does the job, but could Medigap make it better? Your neighbor thinks so. Even the guy at the pharmacy has an opinion. So here’s the real deal—straight from “The Long View” episode with Phil Moeller, author of “Get What’s Yours for Medicare.” He breaks down Medicare and Medigap, and how to make smarter choices—minus the guesswork.
Let’s break it down—starting with what you really need to know.
- Original Medicare: Basic government health coverage for hospital and doctor visits.
- Medicare Advantage: A Private plan that bundles Medicare with extra benefits.
- Medigap: Add-on insurance that helps pay costs not covered by Original Medicare.
Low-Income Support Makes Original Medicare More Attractive
For people with tighter budgets, Medicare programs can make a big difference. They help pay for prescription drugs (covered under Part D) and medical services like doctor visits, lab work, and outpatient care (covered under Part B). This extra help can make traditional Medicare more manageable and appealing—especially for those dealing with chronic conditions or frequent care needs.
According to Phil Moeller, over 10 million Americans use Medicare’s low-income assistance programs, like the “help” program, which reduces the cost of Part D prescriptions. Millions more qualify but haven’t signed up.
Medigap Isn’t Always Affordable, Especially If You Switch Late
Many people assume they can switch to a Medigap plan at any time. However, if a major health issue arises and you attempt to switch from Medicare Advantage to Original Medicare with Medigap, it may be too late, as timing is crucial.
Say you’re healthy at 65 and pick a Medicare Advantage plan to save money. Five years later, you’re diagnosed with a serious condition and want to switch. At this juncture, a Medigap plan could cost more or reject your application altogether.
Planning early can protect you from this pitfall.
Insurance Brokers Don’t Always Show You The Full Picture
About a third of Medicare enrollees work with private insurance brokers, Moeller notes. But many of these brokers recommend plans based on commission, not necessarily what’s best for you. It’s like walking into a Toyota dealership—you won’t hear much about Fords. So take their advice with a grain of salt, then do your own research to explore all your options.
The good news, though, is that…
Medigap Can Eliminate Most Out-of-Pocket Surprises
This is one of the most convincing arguments in Medigap’s favor. For people managing serious medical conditions or expensive drugs, it offers peace of mind and significant savings. When costs balloon, Medigap acts as a buffer to help you focus on recovery.
All Medigap Plans Cover The Same Services—But Prices Vary Widely
There are 10 standardized Medigap plans, labeled A through N. That means a Plan G from one insurer must offer the same coverage as a Plan G from another. But the monthly premium can vary widely, depending on state rules, company pricing strategies, and other factors that aren’t always clear or easy to compare, Moeller explains.
That’s why it’s smart to shop around and avoid overpaying. Don’t get distracted by extras like gym memberships; they’re not what you’re really buying.
And here’s one last thing people often overlook.
The Real Value Might Be Peace Of Mind
Knowing that one medical emergency won’t wipe out your savings can be a game-changer. When you feel protected, your overall financial planning gets easier, too. That calm is worth more than you might think.
In this regard, Moeller describes the “head-on-the-pillow” test: when you know you’re covered, you sleep better. Predictable healthcare costs ease the financial stress many face later in life.
To get that peace of mind, the key is to plan—choose a Medigap + Medicare plan early while your health still qualifies you, compare premiums, and understand what each plan covers. That way, you avoid last-minute stress and enjoy real confidence in your coverage.
