Original Medicare, Medicare Advantage, Medigap and Part D, compared side by side in plain English.
Samantha Lewis Agency is a Medicare broker in Livonia, MI, helping people turning 65 and current Medicare members make sense of Original Medicare, Medicare Advantage, Medigap and Part D. We start with your doctors, your prescriptions and your budget, then compare plans side by side in plain English.
A Medicare broker is a licensed advisor who compares plans from several insurance companies instead of selling just one. At Samantha Lewis Agency in Livonia, we check your doctors and prescriptions, compare total yearly costs, explain the trade-offs and help you enroll. Brokers are paid by the insurers, so our help usually costs you nothing extra.
Medicare has four parts. Part A is hospital insurance, Part B is medical insurance for doctor visits and outpatient care, Part C is Medicare Advantage, an all-in-one alternative offered by private insurers, and Part D covers prescription drugs. Together, Parts A and B are called Original Medicare. Medigap, also called Medicare Supplement, is separate coverage that helps pay Original Medicare’s out-of-pocket costs.
| Part | What it is | How you get it |
|---|---|---|
| Part A | Hospital insurance, such as inpatient stays | Through Medicare (Original Medicare) |
| Part B | Medical insurance: doctor visits, outpatient and preventive care | Through Medicare (Original Medicare) |
| Part C | Medicare Advantage: private plans combining Parts A and B, often with drug coverage | From private insurers approved by Medicare |
| Part D | Prescription drug coverage | Stand-alone plan or inside a Medicare Advantage plan |
| Medigap | Medicare Supplement: standardized lettered plans, such as Plan G and Plan N | From private insurers, alongside Original Medicare |
Medicare Advantage usually means lower monthly premiums with copays, a provider network and often built-in drug coverage. Medigap pairs with Original Medicare, typically has a higher premium, and helps cover deductibles and coinsurance, with any doctor who accepts Medicare. The better fit for Livonia residents depends on your doctors, prescriptions, travel plans and how much cost predictability you want.
| Medicare Advantage (Part C) | Original Medicare + Medigap | |
|---|---|---|
| Monthly premium | Often lower; you still pay your Part B premium | Usually higher; you pay your Part B premium plus the Medigap premium |
| Costs when you get care | Copays and coinsurance, up to the plan’s yearly out-of-pocket limit | Depends on the lettered plan; often little left to pay |
| Doctors and hospitals | Usually a network (HMO or PPO) | Any provider in the US that accepts Medicare |
| Prescription drugs | Often included | Not included; add a separate Part D plan |
| Switching later | Can change during the Annual Enrollment Period | Buying a Medigap policy outside your Medigap Open Enrollment may involve health questions |
If you see specialists often, travel, or prefer predictable costs, Medigap is often worth a look. We will show you both, using your actual doctors and drug list.
Part D is Medicare’s prescription drug coverage, sold by private insurers as a stand-alone plan or included in many Medicare Advantage plans. Each plan has its own drug list, called a formulary, plus pharmacy network and cost tiers. Part D now has an annual out-of-pocket cap on covered drugs, set by Medicare each year, which limits what you pay for covered prescriptions.
The cap comes from the Inflation Reduction Act, and Medicare sets the amount each year; Medicare.gov lists the current figure. Plans still differ in premiums, deductibles, covered drugs and preferred pharmacies, so we compare using your exact medications and pharmacy.
You can first enroll during your Initial Enrollment Period, the seven months around your 65th birthday. After that, the Annual Enrollment Period runs October 15 to December 7, 2026, for coverage starting January 1, 2027. Medicare Advantage members also get one change from January 1 to March 31, 2027. Medigap has its own six-month open enrollment window.
For this fall, see our Medicare Annual Enrollment Period cheat sheet for Michigan. Leaving job-based coverage? Our health insurance broker team in Livonia can help you plan the switch.
It depends on the plan’s network. Many Medicare Advantage plans use HMO or PPO networks, and networks can change from year to year. Before you enroll, we check your doctors, specialists and preferred hospitals against each plan, so you know who is in network.
Medigap policies sold today do not include prescription drug coverage, so most people with Original Medicare and Medigap also add a stand-alone Part D plan. If you have other creditable drug coverage, such as from an employer, you may not need one yet. We can help you confirm which applies.
If you miss it and do not qualify for a Special Enrollment Period, you can generally sign up for Part A or Part B during the General Enrollment Period, January 1 to March 31. Coverage may start later than you want, and late enrollment penalties can apply, so it is worth planning your sign-up before you turn 65.
Both are standardized, so the benefits of a Plan G are the same from every insurer, and the same is true for Plan N. Plan G generally covers more of the gaps, while Plan N usually costs less each month in exchange for some copays. We compare premiums from several carriers and look at how you use care before recommending either.
MMAP, the Michigan Medicare/Medicaid Assistance Program, offers free, unbiased Medicare counseling to Michigan residents. A licensed broker like Samantha Lewis Agency can also compare specific plans, check your doctors and drugs, and complete your enrollment, and that help usually costs you nothing extra.
Yes, it is a good habit. Plans can change premiums, copays, drug lists and networks each year, and your prescriptions change too. A short review before December 7 helps you catch changes in your Annual Notice of Change and decide whether to keep your plan or switch for January 1.
Ready to compare Medicare plans? Request a Medicare quote, Book a free consultation or call (734) 525-9450.
Book a no-obligation call with Samantha or call us directly.
