Medicare Advantage (MA) plans now serve more than half of Medicare-eligible individuals. At the same time, Medicare Supplement plans, also known as Medigap, continue to show strong demand, with enrollment projected to grow from 14.3 million to 17 million by 2031.
For licensed agents, this points to an important reality: both Medicare Advantage and Medigap remain essential parts of a well-rounded portfolio.
While MA plans continue to dominate the market, Medigap plans still appeal to many beneficiaries who value predictable coverage, provider flexibility, and the ability to pair Original Medicare with supplemental protection. In many cases, starting with Original Medicare and a Medicare Supplement plan can give beneficiaries more flexibility, including the option to move to Medicare Advantage later.
However, moving from Medicare Advantage back to Original Medicare with a Supplement plan can be more difficult. Outside certain guaranteed issue situations, beneficiaries may be subject to underwriting, unless they are within their first 12 months of trying a Medicare Advantage plan.
As the Medicare market continues to evolve, licensed agents need to understand how both types of coverage fit different consumer needs, budgets, and long-term preferences.
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Recent and proposed changes from the Centers for Medicare & Medicaid Services may affect how Medicare Advantage plans are structured and positioned. One major development is the $2,000 annual out-of-pocket cap for prescription drugs, which applies to Part D deductibles, copayments, and coinsurance.
In response to changing cost pressures, some MA plans may adjust formularies, increase coinsurance, reduce certain extra benefits, or make other plan design changes.
These shifts reinforce the importance of maintaining a diverse portfolio that includes both Medicare Advantage and Medicare Supplement options. A broader portfolio allows licensed agents to better serve consumers with different priorities while also helping create commission opportunities outside of the Medicare Advantage Annual Election Period.
When discussing Medicare Supplement plans, Plan G and Plan N are two of the most common options.
Plan G offers broad coverage and helps pay Medicare-approved costs after the Part B deductible is met, including Part B excess charges where applicable.
Plan N typically offers lower premiums in exchange for certain cost-sharing, such as copayments for doctor visits and emergency room visits.
The right fit often depends on the consumer’s budget, health care usage, and comfort level with out-of-pocket costs. For consumers concerned about monthly premium increases, Plan N may offer a strong balance of affordability and coverage. High-deductible Plan G may also appeal to those who want lower monthly premiums and are comfortable with a higher deductible before fuller coverage begins.
Many carriers also include added services or discounts with their Medigap plans. These may include access to fitness programs, hearing aid discounts, vision or dental savings programs, or other value-added benefits.
While these extras should not replace a thorough coverage comparison, they can help strengthen the overall value proposition when presenting plan options to consumers.
To better serve consumers in today’s Medicare market, agents should focus on a few key strategies:
Educate consumers on all plan options. A strong understanding of MA and Medigap benefits, costs, provider access, prescription drug coverage, and enrollment rules allows agents to guide more informed conversations.
Highlight available extras and discounts. When appropriate, explain added services that may come with a plan, such as fitness programs or hearing aid savings.
Maintain a diverse portfolio. Offering both MA and Medigap options helps agents meet a wider range of consumer needs and support year-round sales opportunities.
Use carrier incentive programs strategically. Many carriers offer incentives that can help agents increase earnings while expanding product awareness.
Stay current on industry changes. Medicare rules, carrier benefits, plan designs, and consumer expectations continue to change. Agents who stay informed are better positioned to provide relevant, compliant support.
| Client Situation / Priority | Medicare Advantage May Be a Better Fit When… | Medigap May Be a Better Fit When… |
|---|---|---|
| Monthly premium sensitivity | The client wants a lower monthly premium and is comfortable with copays, coinsurance, and plan rules. | The client is willing to pay a higher monthly premium for more predictable medical costs. |
| Provider flexibility | The client’s preferred doctors, hospitals, and specialists are in the plan’s network. | The client wants broader provider access with any provider that accepts Medicare. |
| Travel habits | The client receives most care locally and does not need broad access outside the service area. | The client travels often, lives in multiple states, or wants more flexibility when seeking care away from home. |
| Prescription drug coverage | The client wants medical and drug coverage bundled into one plan, when available. | The client is comfortable pairing Original Medicare and Medigap with a separate Part D plan. |
| Extra benefits | The client values benefits such as dental, vision, hearing, fitness, transportation, or OTC allowances. | The client is less focused on extras and more focused on medical cost predictability and provider choice. |
| Out-of-pocket risk tolerance | The client is comfortable with variable out-of-pocket costs up to the plan’s annual maximum. | The client prefers to reduce exposure to unpredictable Medicare-approved medical costs. |
| Care coordination | The client likes the idea of managed care, referrals or network coordination, depending on plan type. | The client prefers fewer plan-based restrictions and less reliance on network rules. |
| Health status and usage | The client is relatively healthy, uses predictable local care, and confirms their providers and prescriptions fit the plan. | The client has frequent care needs, sees multiple specialists, or wants fewer concerns about networks. |
| Enrollment timing | The client is in a valid MA enrollment period and understands annual plan review is important. | The client is in their Medigap Open Enrollment Period or has guaranteed issue rights. Outside of those windows, underwriting may apply. |
| Long-term flexibility | The client understands that MA plans can change annually and should be reviewed each year. | The client wants a more stable coverage structure, while recognizing premiums can increase over time. |
Agent note: This table should be used as a conversation guide, not a one-size-fits-all recommendation. Medicare.gov advises consumers to compare provider access, costs, coverage, and travel needs when deciding between Original Medicare and Medicare Advantage.
The Medicare landscape is evolving quickly. Medicare Advantage remains a major force in the market, while Medicare Supplement plans continue to grow and appeal to consumers who value flexibility and predictable coverage.
Successful licensed agents will be those who lead with education, transparency, and a diverse portfolio of solutions. By offering both MA and Medigap options, agents can better serve their clients, adapt to market changes, and create more consistent opportunities throughout the year.
Having the right Medicare portfolio matters. PSM Brokerage gives independent agents access to competitive Medicare Advantage, Medicare Supplement, PDP, and ancillary carriers, along with the training, marketing support, contracting assistance, and one-on-one guidance needed to grow with confidence.
Whether you want to expand your product lineup, strengthen client retention, or create more year-round sales opportunities, PSM is here to help.
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