Medicare Advantage vs. Medigap in Florida: Which Works Better for You?
Choosing between Medicare Advantage and Medigap is a key decision for Florida seniors. Both options offer different paths to coverage beyond Original Medicare. We’ll break down the differences and help you find what fits best in Miami‑Dade.
Original Medicare Basics — What’s Included and What’s Not
Original Medicare covers Part A (hospital) and Part B (medical) services, but leaves gaps like deductibles, coinsurance, and limited extras. Medigap and Advantage offer different ways to bridge these gaps.
What Is Medicare Advantage (Part C)? Pros and Cons
Medicare Advantage (Part C) bundles Part A, Part B, and often Part D (drug coverage) into a single plan, sometimes with extras like dental, vision, or gym benefits, and may include $0 premiums in Florida for 2025.
- Pros: Often low or $0 premiums; all‑in‑one billing; extras like vision, dental, and hearing.
- Cons: Must stay in network; referrals and prior authorizations can delay care; costs vary by use; limited travel coverage.
What Is Medigap (Medicare Supplement)? Pros and Cons
Medigap supplements Original Medicare by covering out‑of‑pocket costs like deductibles and coinsurance. Plans are standardized (A‑D, G, K‑N), and you can see any provider nationwide who accepts Medicare.
- Pros: Predictable costs; broad provider access; easier for frequent travelers or those with specific doctors.
- Cons: Higher monthly premiums; no Part D included—you’ll need a separate drug plan; fewer extras like dental/vision.
Florida‑Specific Considerations: Costs, Networks, and Availability
In Florida, Medicare Advantage premiums average around $4.33/month, with $0 widely available, while Medigap (Plans G & N) average between $121–$171/month for 2025.
Florida offers many Advantage options (over 600 plans in 2025), but network limitations mean less flexibility if you travel between Miami‑Dade and other states.
Who Might Prefer Each Option — Scenario Guide for Miami‑Dade Seniors
- Choose Medicare Advantage if you: want low or $0 premiums plus extras and typically stay within local networks.
- Choose Medigap if you: value flexibility to travel, see any doctor nationwide, have chronic conditions requiring frequent care, or want predictable out‑of‑pocket costs.
How to Decide: Checklist + Local Resources
Use this checklist:
- Compare plan costs—monthly premium, max out‑of‑pocket.
- Check if your doctors participate (Advantage network vs. Medigap flexibility).
- Assess extras that matter: dental, vision, transportation, fitness.
- Plan for drug coverage—Part D is often included in Advantage plans; add separately with Medigap.
- Speak with your local SHIP office or call (305) 878-4154 or book a consultation for help tailored to Miami‑Dade.
FAQs
- Can I switch between plans later?
- Yes. Medicare Advantage can be changed during Open Enrollment or special periods. Medigap can be purchased when newly eligible to avoid underwriting delays.
- What if I see specialists often?
- Medigap offers greater flexibility to choose providers without referrals, often preferred for chronic or specialist care.
- Is drug coverage included?
- Medicare Advantage usually includes Part D; with Medigap, you’ll need to add it separately.
Next Steps
Let’s find a plan that fits your life in Miami‑Dade. Call (305) 878-4154 book a consultation today.