Medicare Advantage vs Medicare Supplement

How the two actually differ

1. One keeps Original Medicare, the other replaces it. A supplement policy sits behind Original Medicare: the government stays the payer, the policy pays some of what the government does not, and the card in front stays the same. A Medicare Advantage plan is the opposite arrangement. The government pays a private insurer to take the whole risk, and that insurer becomes the payer, with its own card, its own rules and its own network. Everything else that people argue about follows from that one structural difference rather than from the marketing around it.
2. Networks and referrals follow from who is paying. Because Original Medicare is a nationwide programme, a supplement rides on it and travels with it. Because an Advantage plan is one insurer's contract, it has the things an insurer's contract has: a network of providers it has negotiated with, and often a requirement to get a referral before seeing a specialist. Neither arrangement is inherently better, and which one is worse for a particular person depends on facts about their doctors and their geography that no comparison table can know.
3. The prices are not comparable in the way people expect. The two do not line up on a premium. A supplement generally charges more each month and less at the point of use; an Advantage plan often charges little or nothing extra each month and more when care happens, up to an annual limit. Comparing only the monthly figure therefore compares nothing, which is why this site quotes no premium at all: the number that would matter is the total across a year of care nobody can predict.
4. Switching later is not symmetrical, and that is the part most pages skip. Moving into an Advantage plan is easy in an enrolment window. Moving back out and buying a supplement can require medical underwriting, depending on the state and on timing, which means the answer can depend on health that has changed since the first decision. This site does not tell anyone what to do about that. It is named here because it is the one asymmetry that makes the first choice weightier than it looks, and because a reader should ask their own State Health Insurance Assistance Program about it rather than an agent paid on the outcome.
5. Read your own state before reading anybody's advice. The split is not national. In the states at the top of this index most people with Medicare have already left Original Medicare, and in the states at the bottom almost nobody has. That does not make either answer right, but it tells you whether the plan being pitched to you is the ordinary choice among your neighbours or an unusual one, and it is the only thing on this page that is a measurement rather than a description.

Common questions

Which one is better?

This site does not answer that and could not. It publishes counts of what people in each state hold, taken from the government's own file. Which arrangement suits a particular person depends on their doctors, their health, their travel, their budget and their state's rules on switching later, and none of that is in any dataset.

Why are there no plan names or prices anywhere on this site?

Deliberately. A site that names a Medicare Advantage or Part D plan and describes its benefits or premiums is marketing under the federal rules that govern this market, and a site that then passes a reader's details to an agent is a Third Party Marketing Organization subject to a whole regime of consent, recording and review. This one publishes federal statistics instead, so it stays a reference and not a sales channel.

Does a high Medicare Advantage share in my state mean the plans there are good?

No. Take-up reflects how heavily plans are marketed and how they are priced at least as much as it reflects how well they work, and this file measures none of that. It measures how many people are enrolled, which is a different and much more reliable thing.

Where should I go for advice about my own situation?

Every state has a State Health Insurance Assistance Program that gives free, unbiased counselling and is not paid on what you choose. Medicare's own helpline and plan finder are the other place to start. We take no enquiries and pass nobody's details to anyone, so there is nothing to send us.

How current are these figures?

They are the most recent annual rows CMS has filed, and the page says which year and which day the file was read. CMS refiles the data periodically; when it does, the ingest re-reads every figure against the new response and fails rather than letting a stale number stand.

Medicare enrollment by state

• Medicare in Alabama
• Medicare in Alaska
• Medicare in Arizona
• Medicare in Arkansas
• Medicare in California
• Medicare in Colorado
• Medicare in Connecticut
• Medicare in Delaware
• Medicare in District of Columbia
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• Medicare in Hawaii
• Medicare in Idaho
• Medicare in Illinois
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• Medicare in Louisiana
• Medicare in Maine
• Medicare in Maryland
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• Medicare in Michigan
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• Medicare in Mississippi
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• Medicare in Nevada
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• Medicare in New Jersey
• Medicare in New Mexico
• Medicare in New York
• Medicare in North Carolina
• Medicare in North Dakota
• Medicare in Ohio
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• Medicare in Oregon
• Medicare in Pennsylvania
• Medicare in Rhode Island
• Medicare in South Carolina
• Medicare in South Dakota
• Medicare in Tennessee
• Medicare in Texas
• Medicare in Utah
• Medicare in Vermont
• Medicare in Virginia
• Medicare in Washington
• Medicare in West Virginia
• Medicare in Wisconsin
• Medicare in Wyoming