If you’re turning 65 or helping a loved one enroll in Medicare, you may feel overwhelmed by all the choices. In Texas, the options can vary depending on where you live. The most common question we hear is: Should I choose Medicare Advantage or Medicare Supplement (Medigap)?
This guide explains what each option offers in simple terms. We’ll compare their costs, coverage, and how they work—so you can choose the one that fits your life best.
- Key Takeaways: Medicare Advantage vs. Medicare Supplement (Medigap)
- What Is Medicare?
- What Is Medicare Advantage?
- What Is Medicare Supplement (Medigap)?
- Side-by-Side Comparison
- Pros and Cons
- How to Decide in Texas
- Questions We Hear Often at EIMA Health
- Conclusion: Choosing the Plan That Works for You
- Frequently Asked Questions (FAQs)
- What is the difference between Medicare Advantage and Medicare Supplement?
- Can I have both Medicare Advantage and Medigap at the same time?
- Do I need a separate drug plan with Medigap?
- Which option lets me see any doctor?
- Are there extra benefits with Medigap plans?
- Can I switch from Medicare Advantage to Medigap later?
- When can I change my Medicare plan?
- Can I get help enrolling my parent or spouse?
- How do I know which plan is right for me?
- Does EIMA Health charge for its help?
Key Takeaways: Medicare Advantage vs. Medicare Supplement (Medigap)
- Medicare Advantage and Medigap are two different ways to get coverage beyond Original Medicare.
- Advantage plans bundle services and often include extras like dental and vision.
- Medigap helps pay out-of-pocket costs and offers more provider flexibility.
- Advantage plans bundle services and often include extras like dental and vision.
- Medicare Advantage plans typically cost less each month but have networks and variable copays.
- Good for those who stay local and want a lower premium.
- Good for those who stay local and want a lower premium.
- Medigap plans have higher premiums but allow you to see any doctor who accepts Medicare.
- Better for frequent travelers or those who want predictable costs.
- Better for frequent travelers or those who want predictable costs.
- Prescription drug coverage is included in most Advantage plans but must be purchased separately with Medigap.
- You can only enroll or make changes to your plan during specific times of the year.
- Annual Enrollment: October 15 – December 7
- Medicare Advantage Open Enrollment: January 1 – March 31
- Annual Enrollment: October 15 – December 7
- Your health, budget, travel habits, and doctor preferences should guide your decision.
- There is no one-size-fits-all plan—what’s right depends on your personal needs.
- There is no one-size-fits-all plan—what’s right depends on your personal needs.
- EIMA Health offers free, personalized support to help you compare plans and enroll confidently.
What Is Medicare?
Medicare is health insurance from the government for people who are 65 or older. It includes:
- Part A: Covers hospital care (like inpatient stays)
- Part B: Covers medical care (like doctor visits and lab tests)
But Medicare doesn’t cover everything. It does not include:
- Most prescription drugs
- Dental, vision, or hearing services
- Long-term care
- All out-of-pocket costs (like deductibles and copays)
To help with these gaps, many Texans choose between two main options:
- Medicare Advantage (Part C): A private plan that includes hospital, doctor, and usually drug coverage.
- Medicare Supplement (Medigap): A private plan that helps pay leftover costs from Original Medicare. You’ll also need a separate plan for prescriptions.
What Is Medicare Advantage?
Medicare Advantage plans are offered by private insurance companies. These plans are approved by Medicare and must cover at least the same services as Original Medicare.
Most plans also include:
- Prescription drug coverage (Part D)
- Extra benefits like dental, vision, hearing, fitness, and transportation
- A provider network (you may need to choose doctors from a list)
You’ll usually need to choose a main doctor and get referrals for specialists. These plans also set a yearly limit on how much you’ll pay for medical care.
Example: Ms. Garcia is 68 and lives in Dallas. She’s retired and wants a low-cost plan that includes dental and vision. She’s happy using nearby doctors in a network. A Medicare Advantage plan works well for her.
What Is Medicare Supplement (Medigap)?
Medigap plans help pay for things like deductibles, copays, and coinsurance. These plans are also from private companies and work alongside your Original Medicare coverage.
They don’t include drug coverage, so you’ll need to buy a separate Part D plan. But Medigap gives you more freedom:
- You can see any doctor in the U.S. who accepts Medicare
- You don’t need referrals to see specialists
- Your costs are more predictable
Example: Mr. Harris is 70 and travels often. He wants to see doctors in different states without worrying about networks. He picks Medigap Plan G and adds a drug plan.
Side-by-Side Comparison
| Feature | Medicare Advantage | Medicare Supplement |
| Monthly Cost | Often $0 or low | Higher |
| Out-of-Pocket Costs | Copays, coinsurance | Lower after premium |
| Drug Coverage | Usually included | Requires a separate plan |
| Doctor Choice | In-network only | Any Medicare-accepting provider |
| Referrals Needed | Usually yes | No |
| Dental, Vision, etc. | Often included | Not included |
| Travel Coverage | Usually limited | Nationwide |
| Best Fit For | Local, cost-saving care | Frequent travelers, flexibility |
Pros and Cons
Medicare Advantage Pros:
- Lower monthly cost
- All-in-one plan for medical, hospital, and prescriptions
- Extra benefits like dental and vision
- Annual cap on what you spend out of pocket
Medicare Advantage Cons:
- You must use doctors in your network (HMO/PPO)
- Some services may need approval first
- Plans can change yearly
- Not great for out-of-state care
Medicare Supplement Pros:
- Freedom to see any Medicare doctor
- No referrals needed
- Fewer surprise bills
- Plans stay the same year after year
Medicare Supplement Cons:
- Higher monthly premium
- Doesn’t include drug coverage (Part D needed)
- No extras like dental or vision
- May be harder to enroll later if you wait
How to Decide in Texas
Ask yourself these questions:
- Can I afford a higher monthly cost now to pay less later?
- Do I want the freedom to choose any doctor?
- Will I be traveling often?
- Do I want extras like dental and vision built into the plan?
- Do I need prescription coverage included or separate?
Also, remember:
- October 15 to December 7 is the Annual Enrollment Period to change or switch plans.
- January 1 to March 31 is when you can switch between Medicare Advantage plans.
Questions We Hear Often at EIMA Health
Can I switch from Medicare Advantage to a Supplement later?
Yes, but you may need to answer health questions unless you’re in a special enrollment window.
Does Medigap cover dental or glasses?
No. You’d need to buy a separate dental or vision plan.
Do I need a main doctor in Medicare Advantage?
Usually yes, especially in HMO plans.
Can I keep my current doctor?
With Advantage, only if they’re in-network. With Medigap, any Medicare doctor is covered.
Can I get help enrolling my parent or spouse?
Yes. At EIMA Health, we help families through the process every day.
Conclusion: Choosing the Plan That Works for You
Both Medicare Advantage and Medigap can be good choices—it depends on what works better for your health, budget, and lifestyle.
- Choose Medicare Advantage if you want a lower-cost, all-in-one plan and don’t mind using network doctors.
- Choose Medigap if you want more flexibility and fewer surprise bills, even if the monthly cost is higher.
If you’re unsure, you don’t have to figure it out alone.
EIMA Health is a trusted local agency based in Dallas. We offer free, personal help to compare plans, answer questions, and guide you from start to finish.
📞 Call us today at (972) 728-0386
💻 Or visit https://eimahealth.com/contact-us/ to book your free appointment.
We’re here to help you feel confident and covered—today and every day after.
Frequently Asked Questions (FAQs)
What is the difference between Medicare Advantage and Medicare Supplement?
Medicare Advantage (Part C) is a private plan that combines Medicare Part A, Part B, and usually Part D (prescription drugs) into one package, often with extra benefits like dental or vision. Medicare Supplement (Medigap) helps pay costs like deductibles and copays that Original Medicare doesn’t cover—but it doesn’t include drug coverage.
Can I have both Medicare Advantage and Medigap at the same time?
No. You can only enroll in one or the other. If you have a Medicare Advantage plan, you cannot use a Medigap plan, and vice versa.
Do I need a separate drug plan with Medigap?
Yes. Medigap plans do not include prescription drug coverage. You’ll need to purchase a separate Part D plan to cover your medications.
Which option lets me see any doctor?
Medigap allows you to see any doctor in the U.S. who accepts Medicare—no network restrictions. Medicare Advantage plans often require you to stay in a network and may require referrals for specialists.
Are there extra benefits with Medigap plans?
No. Medigap plans do not include extras like dental, vision, or hearing coverage. You would need to buy separate plans for those services.
Can I switch from Medicare Advantage to Medigap later?
Yes, but you may need to answer health questions and could be denied coverage unless you’re in a special enrollment window. It’s best to make this decision when you first become eligible for Medicare.
When can I change my Medicare plan?
Annual Enrollment Period (Oct. 15 – Dec. 7): Change or enroll in Medicare Advantage or Part D plans.
Medicare Advantage Open Enrollment (Jan. 1 – Mar. 31): Switch between Advantage plans or go back to Original Medicare.
Can I get help enrolling my parent or spouse?
Yes. EIMA Health helps family members and caregivers with Medicare questions and enrollment every day. You’re not alone.
How do I know which plan is right for me?
It depends on your health needs, budget, whether you travel, and which doctors you want to see. Talking to a licensed agent can help you make the best choice.
Does EIMA Health charge for its help?
No. EIMA Health provides 100% free assistance with Medicare plan comparisons, enrollment, and year-round support.
This article has been a collaboration between EIMA Health and OpenAI’s ChatGPT. Created on Sep 29, 2025, it combines AI-generated draft material with EIMA Health’s expert revision and oversight, ensuring accuracy and relevance while addressing any AI limitations.
