Comparison Overview

An EGHP vs. Medicare comparison table should line up the three columns—Employer Group Health Plan (EGHP), Original Medicare (Parts A & B, add Part D + Medigap as needed), and Medicare Advantage (Part C)—across the factors people actually decide on: eligibility & timing (active worker/spouse vs. age 65+; SEP rules; COBRA/retiree nuances), who’s primary payer (EGHP often primary if the employer has 20+ employees; Medicare primary for smaller groups), premiums & contributions (payroll deductions vs. Part B/D premiums and Medigap/MA plan premiums), out-of-pocket exposure (EGHP deductible/OOP max vs. Original Medicare’s cost shares with optional Medigap vs. MA plan MOOP), provider access (broad any-doctor who takes Medicare with Original Medicare vs. HMO/PPO networks and prior authorization in MA vs. employer network rules in EGHP), drug coverage (EGHP Rx vs. stand-alone Part D vs. MA-PD), extras (vision/dental/fitness more common in EGHP/MA than Original Medicare), HSA implications (active HSA contributions require delaying Part A), travel/portability (Original Medicare nationwide; MA network-dependent; EGHP varies), and penalty risk & coordination (creditable EGHP lets you delay Part B/Part D without penalties; non-creditable drug coverage triggers Part D LEP). Add rows for care management (referrals/prior authorization), appeals, out-of-network coverage, and total annual cost to make the trade-offs clear at a glance.