Medicare Plans
Medicare Advantage vs. Medicare Supplement in Waco, TX
Almost every Waco senior we meet is deciding between the same two paths: a Medicare Advantage plan that bundles everything into one low-premium private plan, or a Medicare Supplement (Medigap) policy that sits behind Original Medicare and pays what Medicare doesn't.
Neither one is better in the abstract. The right answer depends on your doctors, your prescriptions, how often you travel, and how much monthly cost you'd rather trade for predictability.
- Two different ways to cover the gaps in Original Medicare
- Network access at Hillcrest and Providence is the local deciding factor
- Premiums are only half the cost picture
- Free side-by-side comparison for McLennan County residents
Side by side
How the two paths actually differ
| Compare | Medicare SupplementMedigap · pairs with Original Medicare | Medicare AdvantagePart C · all-in-one private plan | Part D Drug PlanPrescriptions only · add-on |
|---|---|---|---|
| What it covers | Your share of Part A and Part B costs — deductibles, copays and coinsurance. | Hospital, medical and usually drugs, bundled into one plan with one card. | Prescription medications only. Nothing medical. |
| Doctor networks | None. Any provider in the U.S. who accepts Medicare. | HMO or PPO network. Verify Baylor Scott & White Hillcrest or Ascension Providence. | Pharmacy network only — preferred pharmacies cost less. |
| Monthly premium | Highest of the three, plus your Part B premium. | Often $0, plus your Part B premium. | Low monthly premium, plus your Part B premium. |
| Costs when you use care | Little to nothing after the Part B deductible on Plan G. | Copays per visit and per service, capped by an annual out-of-pocket maximum. | Deductible and tiered copays based on the plan's drug list. |
| Prescription drugs | Not included — you must add a separate Part D plan. | Included in most Waco plans. | This is the drug coverage. |
| Extras (dental, vision, hearing) | Not included. Buy standalone if you want them. | Commonly included, with allowances that vary a lot by plan. | Not included. |
| Health questions to enroll | None during your 6-month open enrollment; underwriting applies later. | None — guaranteed acceptance during a valid enrollment period. | None. |
| Best if you | Travel, see specialists often, and want predictable bills. | Are settled with Waco providers and want low premiums plus extras. | Chose Medigap or Original Medicare and need drug coverage. |
| Read more | Medicare Supplement details | Medicare Advantage details | Part D Drug Plan details |
Medicare Supplement
Medigap · pairs with Original Medicare
- What it covers
- Your share of Part A and Part B costs — deductibles, copays and coinsurance.
- Doctor networks
- None. Any provider in the U.S. who accepts Medicare.
- Monthly premium
- Highest of the three, plus your Part B premium.
- Costs when you use care
- Little to nothing after the Part B deductible on Plan G.
- Prescription drugs
- Not included — you must add a separate Part D plan.
- Extras (dental, vision, hearing)
- Not included. Buy standalone if you want them.
- Health questions to enroll
- None during your 6-month open enrollment; underwriting applies later.
- Best if you
- Travel, see specialists often, and want predictable bills.
Medicare Advantage
Part C · all-in-one private plan
- What it covers
- Hospital, medical and usually drugs, bundled into one plan with one card.
- Doctor networks
- HMO or PPO network. Verify Baylor Scott & White Hillcrest or Ascension Providence.
- Monthly premium
- Often $0, plus your Part B premium.
- Costs when you use care
- Copays per visit and per service, capped by an annual out-of-pocket maximum.
- Prescription drugs
- Included in most Waco plans.
- Extras (dental, vision, hearing)
- Commonly included, with allowances that vary a lot by plan.
- Health questions to enroll
- None — guaranteed acceptance during a valid enrollment period.
- Best if you
- Are settled with Waco providers and want low premiums plus extras.
Part D Drug Plan
Prescriptions only · add-on
- What it covers
- Prescription medications only. Nothing medical.
- Doctor networks
- Pharmacy network only — preferred pharmacies cost less.
- Monthly premium
- Low monthly premium, plus your Part B premium.
- Costs when you use care
- Deductible and tiered copays based on the plan's drug list.
- Prescription drugs
- This is the drug coverage.
- Extras (dental, vision, hearing)
- Not included.
- Health questions to enroll
- None.
- Best if you
- Chose Medigap or Original Medicare and need drug coverage.
Local networks
What this means at Waco hospitals
Medigap: no network at all
If a provider takes Original Medicare, your Medigap plan follows. That covers Baylor Scott & White Hillcrest, Ascension Providence, and specialists in Temple, Dallas or Houston without referrals.Advantage: the network is the plan
Waco Advantage plans differ on which system is in-network. Some contract broadly with Hillcrest, others lean toward Providence. Networks are re-confirmed every January.Drugs are handled differently
Advantage plans usually build Part D in. With Medigap you buy a standalone Part D plan and can shop it separately each fall — often the cheaper route for expensive drugs.
Choose Advantage if
When a Medicare Advantage plan fits
- You want the lowest possible monthly premium, often $0 beyond Part B
- Your doctors and preferred hospital are already in the plan's Waco network
- Extras like dental, vision, hearing and gym membership matter to you
- You're comfortable with copays as you use care and an annual out-of-pocket maximum
- You rarely travel outside Central Texas for routine care
Choose Medigap if
When a Medicare Supplement fits
- You want predictable costs — a monthly premium instead of copays at every visit
- You see multiple specialists, or split time between Waco and another state
- You want to keep any doctor who accepts Medicare, with no referrals
- You have ongoing treatment where per-service copays would add up fast
- You're inside your 6-month Medigap open enrollment window and can enroll without health questions
The timing detail that traps people
You can join or change an Advantage plan each fall during Open Enrollment. Moving back to a Medigap plan later can require health underwriting in Texas. That asymmetry should factor into your first choice.
Total cost
Compare the year, not the premium
A $0-premium Advantage plan is not free. Add up realistic copays for your primary care visits, specialists, imaging, and any planned procedure, then compare that total to a year of Medigap premiums plus a standalone drug plan. For a healthy 66-year-old the Advantage math often wins; for someone with a chronic condition and frequent specialist visits, Medigap frequently costs less over twelve months.
We run that arithmetic with your actual drug list and doctors. Start with the Medicare checklist, or read the mistakes to avoid before you sign anything.
Not sure which side you fall on?
Bring your doctors and prescriptions — we'll price both paths for a full year and show you the difference.