Medicare Plus is not a real program — it's a marketing term

There is no official program called "Medicare Plus." You may have seen this term in advertisements, but it does not exist as a Medicare plan type. Insurance companies sometimes use "Plus" in their product names to sound like an upgrade, but these are regular Medicare Advantage plans (also called Part C) or Medigap policies (also called supplemental insurance). Both add coverage on top of Original Medicare, but they work in completely different ways.

If you have seen "Medicare Plus" advertised, the company is selling either a Medicare Advantage plan or a Medigap policy under a branded name. Before you enroll, you need to know which one it actually is, because the costs, doctors you can see, and what you pay out of pocket are very different between the two.

Key Takeaways

  • "Medicare Plus" is a marketing name, not an official Medicare program — the actual plan is either Medicare Advantage or Medigap.
  • Medicare Advantage plans have lower monthly premiums but require you to use in-network doctors and have yearly out-of-pocket limits.
  • Medigap policies let you see any doctor who accepts Medicare but cost more per month and do not have an out-of-pocket cap.
  • You can only enroll in one or the other, not both, so understanding the difference before you sign up is critical.
  • Your state, age, and current health status all affect which plans are actually available to you and what they cost.

Medicare Advantage plans sold as "Medicare Plus"

Most "Medicare Plus" advertisements are for Medicare Advantage plans. These are insurance plans run by private companies that contract with Medicare. They cover everything Original Medicare covers (hospital, doctor visits, prescription drugs) but often with lower monthly premiums — sometimes zero premium beyond what you already pay for Medicare Part B.

The trade-off is that you must use doctors and hospitals in the plan's network. If you see an out-of-network doctor, you pay more or the plan may not cover it at all. You also have a yearly out-of-pocket maximum — once you hit that number, the plan covers the rest of your care for that year. This can be helpful if you have expensive medical needs, but it also means you could pay thousands before the plan takes over.

Medicare Advantage plans often include extras that Original Medicare does not, such as dental, vision, or hearing coverage. However, these extras vary widely by plan and by region. The plan available to you in your zip code may be completely different from the plan available to your neighbor.

Medigap policies sold as "Medicare Plus"

Some insurance companies sell Medigap policies (supplemental insurance) under names that include "Plus." A Medigap policy works alongside Original Medicare — you keep your Original Medicare coverage and add the Medigap policy on top to cover costs that Medicare does not pay, such as copayments, coinsurance, and deductibles.

With Medigap, you can see any doctor or hospital that accepts Medicare, anywhere in the country. There are no networks and no referrals required. However, Medigap policies cost more per month than Medicare Advantage plans, and there is no yearly out-of-pocket maximum. If you have high medical costs, you could pay thousands in premiums plus your share of costs.

Medigap comes in standardized plans labeled A through N (and G and M in some states). Each letter represents a specific set of benefits, so a Plan G from one insurance company covers the same things as a Plan G from another company. The price varies by company and by state, but the coverage does not.

How to tell which one you are looking at

When you see "Medicare Plus" in an advertisement, look for these clues to figure out what you are actually being sold:

  • Does the ad mention a network of doctors or hospitals? If yes, it is Medicare Advantage.
  • Does the ad say you can see any doctor who accepts Medicare? If yes, it is Medigap.
  • Does the ad mention prescription drug coverage as part of the plan? If yes, it is Medicare Advantage (Medigap does not include drug coverage).
  • Does the ad mention an out-of-pocket maximum or yearly limit on what you pay? If yes, it is Medicare Advantage.
  • Is the plan name a letter (Plan A, Plan G, Plan N)? If yes, it is Medigap.

You can also call the insurance company directly and ask: "Is this a Medicare Advantage plan or a Medigap policy?" They are required to tell you clearly.

When you can enroll and what it costs

You can enroll in Medicare Advantage or Medigap during your Initial Enrollment Period, which is the seven months that start three months before the month you turn 65. You can also enroll during the yearly Annual Enrollment Period from October 15 to December 7, when you can switch plans or drop coverage.

If you miss these windows, you may have to wait until the next Annual Enrollment Period, or you may pay a penalty if you enroll later. The penalty for Medigap can be permanent — if you wait to enroll after your Initial Enrollment Period ends, some insurance companies can charge you more based on your health history.

Costs vary by state, by insurance company, and by the specific plan. Medicare Advantage premiums can be as low as zero dollars per month, but you will pay when you see a doctor. Medigap premiums are typically $100 to $300 per month, depending on your age and location, but you pay little or nothing when you see a doctor. There is no way to know your exact cost without getting quotes from plans available in your zip code.

Questions to ask before you enroll

Before you sign up for any plan called "Medicare Plus," ask the insurance company or your broker these questions:

  • Is this a Medicare Advantage plan or a Medigap policy?
  • What is the monthly premium, and what else will I pay when I see a doctor?
  • Can I see my current doctors, or do I need to switch?
  • Does this plan cover prescription drugs?
  • What is the yearly out-of-pocket maximum, if there is one?
  • Can I switch to a different plan next year, or am I locked in?

Write down the answers and compare them side by side with other plans available in your area. You can also call 1-800-MEDICARE to speak with someone who can explain your options without trying to sell you anything.

Frequently Asked Questions

Is Medicare Plus the same as Medicare Advantage?

No. Medicare Advantage is the official name for Part C plans. "Medicare Plus" is a brand name that insurance companies use for either Medicare Advantage or Medigap. You have to check which one you are actually buying.

Can I have both Medicare Advantage and Medigap at the same time?

No. Medicare rules do not allow you to enroll in both. You choose one or the other. If you have both, Medicare will contact you and ask you to drop one.

What happens to my "Medicare Plus" plan if I move to a different state?

Medicare Advantage plans are only available in specific service areas, so your plan may not be available in your new state. You would need to enroll in a different plan during your Annual Enrollment Period. Medigap policies work in all states, but the price and available plans vary by state.

Do I still pay my Medicare Part B premium if I have a "Medicare Plus" plan?

Yes. Whether you choose Medicare Advantage or Medigap, you must keep paying your Part B premium. Some Medicare Advantage plans have zero additional premium, but you still pay Part B. Medigap does not replace Part B — it only covers costs that Part B does not pay.

What if I enroll in a "Medicare Plus" plan and hate it?

You can switch to a different plan during the Annual Enrollment Period (October 15 to December 7) or during the Medicare Advantage Disenrollment Period (January 1 to February 14). Outside these windows, you are locked in until the next enrollment period unless you have a may have access to life event like moving or losing other coverage.