Medicare Advantage vs. Medicare Supplement (Medigap): A Complete Guide

Medicare Advantage vs. Medigap: Why This Choice Matters

When people first become eligible for Medicare, one of the most confusing decisions is figuring out what they actually need beyond basic Medicare. The terminology can make the process even harder. Medicare Advantage is sometimes called Part C. Medicare Supplement Insurance is commonly called Medigap. Both are sold by private insurance companies, but they perform very different functions.

Understanding the difference matters because your choice can affect how you access doctors, how you pay for medical services, whether you need referrals, how prescription coverage is handled, how much you may spend during a year, and how easily you can change coverage later.

Original Medicare consists of Part A and Part B. Part A generally covers inpatient hospital services, skilled nursing facility care, hospice, and certain home health services. Part B generally covers physician services, outpatient care, durable medical equipment, preventive services, and other medically necessary services.

From there, beneficiaries can generally either remain with Original Medicare and add supplemental coverage such as Medigap, or enroll in a Medicare Advantage plan. Medicare Advantage plans are private plans approved by Medicare that provide Part A and Part B benefits and usually include prescription drug coverage.

What Is Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, is an alternative way to receive Medicare-covered health benefits. Instead of receiving Part A and Part B benefits directly through Original Medicare, you enroll in a Medicare-approved private health plan.

Medicare Advantage plans must cover all emergency and urgent care and almost all medically necessary services covered by Original Medicare. Plans may, however, establish different rules for how beneficiaries receive services. For example, a plan may have a provider network, require referrals for some specialists, or require prior authorization for certain services.

Many Medicare Advantage plans also include prescription drug coverage. Some plans provide additional benefits that Original Medicare does not generally cover, such as certain dental, vision, or hearing benefits. Exactly what is included varies from plan to plan.

This means Medicare Advantage is not one single standardized product. Two Medicare Advantage plans in the same city can have different premiums, networks, copayments, drug formularies, prior authorization rules, supplemental benefits, and out-of-pocket limits.

How Medicare Advantage works

To join Medicare Advantage, you generally need both Medicare Part A and Part B. You continue paying your Part B premium, although some Medicare Advantage plans may help pay all or part of the Part B premium.

You then receive covered Medicare services through the Medicare Advantage plan according to its rules. Instead of simply paying Original Medicare's standard cost-sharing structure for every service, you may have plan-specific copayments or coinsurance.

For example, one plan might charge a fixed copayment for a primary-care visit, another amount for a specialist visit, and another amount for outpatient hospital services. The plan's Evidence of Coverage explains the specific rules.

Medicare Advantage networks

Provider networks are one of the most important differences between Medicare Advantage and Original Medicare. Depending on the plan type, you may be expected to use doctors, hospitals, pharmacies, and other providers that participate in the plan's network.

Emergency and urgent care must be covered, but routine care can be subject to network rules. Some plans allow more flexibility outside the network, while others provide little or no coverage for non-emergency out-of-network care.

Before joining a plan, it is therefore important to verify more than just whether your doctor accepts Medicare. You should determine whether your doctor is actually in the specific Medicare Advantage plan's network.

Prior authorization

Some Medicare Advantage plans require prior authorization for certain services, procedures, treatments, or equipment. This means the plan may need to approve the service before it is covered according to the plan's rules.

Prior authorization can be especially important for people who regularly receive specialized care. Before enrolling, review the plan's rules for services you expect to use rather than assuming that Medicare Advantage operates exactly like Original Medicare.

What Is Medicare Supplement Insurance (Medigap)?

Medicare Supplement Insurance, commonly called Medigap, is private insurance designed to help pay certain costs that remain after Original Medicare pays its share.

Medigap does not replace Original Medicare. Instead, it works with Original Medicare Part A and Part B. You generally need Part A and Part B to purchase a Medigap policy.

Medigap policies can help pay certain deductibles, coinsurance, and copayments. The exact benefits depend on the Medigap plan letter you choose. Standardized Medigap plans are identified by letters in most states.

An important advantage of standardization is that the benefits associated with a particular plan letter are standardized. For example, if you compare the same standardized Medigap plan from different insurers, the covered benefits are generally the same. The premiums, customer service, company reputation, availability, and other insurer-specific factors can differ.

Medigap does not replace Original Medicare

This distinction is essential. If you have Original Medicare and Medigap, Medicare remains your primary health coverage for Medicare-covered services. Medigap then helps with certain remaining costs according to the policy's benefits.

Medigap generally does not provide the same type of network structure as Medicare Advantage. Because Original Medicare generally allows you to see any doctor or hospital that accepts Medicare, Medigap users can have broad provider access.

However, Medigap does not automatically mean that every medical service is covered. Original Medicare has its own coverage rules, and Medigap generally supplements covered Part A and Part B services rather than replacing Medicare's coverage limitations.

What Medigap generally does not cover

Medigap is not an all-purpose health insurance policy. Medicare.gov notes that Medigap generally does not cover long-term care, routine vision or dental care, hearing aids, glasses, or private-duty nursing. Prescription drug coverage is also generally not included in Medigap policies sold after 2005.

If prescription coverage is needed, a person with Original Medicare and Medigap generally looks separately at Medicare Part D.

Medicare Advantage vs. Medigap: Side-by-Side Comparison

The easiest way to understand the difference is to compare what happens to your Medicare coverage, provider access, costs, prescriptions, and enrollment options.

Medicare Advantage vs. Medigap Costs

Comparing premiums alone can be misleading. A plan with a low monthly premium may still produce significant costs when you use healthcare. Conversely, a policy with a higher monthly premium may reduce your exposure to certain medical bills.

A useful comparison considers the entire potential cost structure: premiums, deductibles, copayments, coinsurance, prescription costs, provider-network rules, out-of-pocket limits, and expected healthcare use.

What Medicare itself costs in 2026

In 2026, the standard Medicare Part B premium is $202.90 per month, although people with higher incomes may pay more because of an income-related monthly adjustment amount. The annual Part B deductible is $283.

Most people do not pay a Part A premium because they or their spouse paid Medicare taxes long enough while working. People who do not qualify for premium-free Part A may have to pay a monthly premium.

Under Original Medicare, Part B-covered services generally involve coinsurance after the deductible. Medicare.gov states that beneficiaries generally pay 20% of the Medicare-approved amount for covered Part B services after meeting the deductible, although the exact situation can depend on the service and provider.

Medicare Advantage costs

Medicare Advantage plans can have premiums as low as $0 beyond the Part B premium, although the absence of an additional plan premium does not mean healthcare is free.

You can still have copayments, coinsurance, deductibles, prescription costs, and other expenses when receiving care. The actual amounts depend on the plan.

One important protection is that Medicare Advantage plans have an annual out-of-pocket limit for covered Medicare services. Once you reach the applicable plan limit for covered services, you generally pay nothing for those covered services for the remainder of the year.

The exact limit and what counts toward it depend on the plan's rules. Prescription drug expenses have their own Part D rules and should be evaluated separately.

Medigap costs

With Medigap, you generally pay your Medicare Part B premium plus a separate premium for your Medigap policy. If you need prescription drug coverage, you may also have a separate Part D premium.

The Medigap premium varies according to factors such as the plan, insurer, location, pricing method, and sometimes age or other rating factors permitted under applicable rules.

The major purpose of Medigap is not necessarily to minimize monthly premiums. Instead, it is designed to help make certain Original Medicare cost-sharing expenses more predictable.

Premium versus predictable costs

Consider two hypothetical beneficiaries.

Person A chooses a Medicare Advantage plan with a relatively low monthly plan premium. That person pays copayments when visiting doctors, receives outpatient treatment, uses prescriptions, or gets other covered services. The plan also has an annual out-of-pocket maximum.

Person B chooses Original Medicare with Medigap. Person B pays a monthly Medigap premium in addition to the Part B premium, but the Medigap plan may cover certain Medicare cost-sharing amounts.

Neither structure can be evaluated solely by looking at the monthly premium. The better financial fit depends on healthcare use, plan benefits, provider preferences, prescription needs, location, and the individual's tolerance for different types of expenses.

Provider Access: One of the Biggest Differences

Provider access is one of the most important practical differences between Medicare Advantage and Medigap.

With Original Medicare, you can generally see any doctor or hospital that accepts Medicare. This can be particularly relevant for people who travel frequently, maintain relationships with specialists in different locations, or want greater flexibility when selecting providers.

Medicare Advantage plans generally operate with plan-specific provider networks. Depending on the plan, going outside the network can mean higher costs or limited coverage for routine care.

This does not mean Medicare Advantage plans cannot provide access to high quality doctors. Rather, the important point is that you need to check whether the specific providers you want are included in the specific plan you are considering.

Questions to ask about doctors

• Is my primary-care doctor in the plan network?
• Are my current specialists in the network?
• Is my preferred hospital in the network?
• What happens if I need care outside the network?
• Do I need referrals for specialists?
• Are there hospitals in another state that I can use for routine care?
• What happens when I travel?

For someone with several established specialists, these questions can be more important than a small difference in monthly premium.

Prescription Drug Coverage: Another Major Difference

Prescription coverage is structured differently depending on which path you choose.

Most Medicare Advantage plans include Medicare prescription drug coverage. This can simplify administration because medical and drug benefits are commonly provided through the same plan.

With Original Medicare and Medigap, prescription drug coverage generally requires a separate Part D plan. Medigap policies sold after 2005 generally do not include prescription drug coverage.

For people who take several medications, prescription coverage deserves detailed attention. Do not simply compare monthly drug-plan premiums. Check whether the plan covers each medication, which tier each drug falls into, whether your preferred pharmacy is considered in-network, and what your expected annual drug costs could be.

Why the drug formulary matters

A formulary is the list of prescription drugs a plan covers. Different Medicare drug plans can cover different medications or place them on different cost-sharing tiers.

A beneficiary who takes only one inexpensive generic medication may have very different drug-plan needs from someone who takes multiple brand-name medications.

Prescription needs can also change over time, which is why reviewing drug coverage annually can be important.

Medicare Advantage Extra Benefits vs. Medigap

One reason Medicare Advantage attracts attention is that some plans offer additional benefits beyond traditional Medicare-covered services.

Depending on the plan, additional benefits can include certain dental, vision, hearing, fitness, transportation, or other supplemental services. These benefits vary considerably by plan and location.

Medigap has a different purpose. Its primary function is helping with certain cost-sharing associated with Original Medicare. Standardized Medigap plans generally do not operate as broad supplemental-benefit packages.

Therefore, when comparing the two, do not simply ask which one has "more benefits." Ask what type of benefits matter to you and whether you are likely to use them.

Can You Have Medicare Advantage and Medigap at the Same Time?

Generally, no. Medigap and Medicare Advantage are not designed to be used together.

A Medigap policy supplements Original Medicare. Medicare Advantage is an alternative way to receive Medicare Part A and Part B benefits.

Medicare.gov specifically states that you cannot use Medigap to pay the premiums, deductibles, copayments, or other cost-sharing associated with a Medicare Advantage plan.

If you move from Original Medicare with Medigap into Medicare Advantage, you may need to drop your Medigap policy. This decision should be made carefully because getting a Medigap policy again later is not necessarily guaranteed under federal law.

Medigap Open Enrollment: Why Timing Matters

One of the most important concepts in Medicare planning is the Medigap Open Enrollment Period.

According to Medicare.gov, the Medigap Open Enrollment Period begins when you are both 65 or older and enrolled in Medicare Part B. It lasts for six months.

During this period, you generally have strong protections when purchasing Medigap. An insurer generally cannot deny you coverage or charge more because of pre-existing health problems during this protected enrollment window.

Once the six-month Medigap Open Enrollment Period ends, federal law does not generally guarantee that an insurer must sell you a Medigap policy. Depending on your circumstances and state law, you may have fewer options, face medical underwriting, or pay more.

This is very different from the annual Medicare Open Enrollment Period. The Medigap Open Enrollment Period is a one-time six-month window and does not repeat every year.

Why this matters for switching decisions

Suppose someone begins Medicare at 65 and chooses Original Medicare plus Medigap. They later switch to Medicare Advantage because the Medicare Advantage plan has a lower monthly premium and offers benefits they want.

Years later, they decide they prefer Original Medicare again.

The person may not necessarily have the same guaranteed ability to buy a Medigap policy that they had during their original Medigap Open Enrollment Period. Certain situations create federal guaranteed-issue rights, and states can provide additional protections, but those protections should never be assumed without checking the person's specific circumstances.

When Can You Switch From Medicare Advantage to Medigap?

Switching between Medicare Advantage and Original Medicare is possible in certain circumstances, but the timing and Medigap rights can be complicated.

During applicable Medicare enrollment periods, a beneficiary may leave a Medicare Advantage plan and return to Original Medicare. However, returning to Original Medicare does not automatically mean that a Medigap company must sell a policy.

Certain situations can provide guaranteed-issue rights. Examples can include circumstances where a Medicare Advantage plan leaves Medicare, stops serving an area, or a beneficiary moves outside the plan's service area. Other federal protections and trial rights can apply in specific circumstances.

Medicare.gov also describes trial rights in certain situations, including specific circumstances involving a person's first Medicare Advantage enrollment.

Because these rights can depend on exactly how and when coverage changed, anyone considering a switch should confirm the applicable rules before dropping existing coverage.

Medicare Advantage vs. Medigap for People Who Travel

Travel can be an important consideration when comparing the two approaches.

Original Medicare generally allows beneficiaries to use any doctor or hospital in the United States that accepts Medicare. This can provide considerable flexibility for people who spend time in different states.

Medicare Advantage plans, by contrast, can have geographic service areas and provider networks. Some plans may offer broader out-of-network benefits, but the rules vary.

People who regularly spend several months away from home should investigate the specific travel rules of a Medicare Advantage plan before enrolling.

International travel

Neither Medicare Advantage nor Medigap should automatically be assumed to provide comprehensive international healthcare coverage.

Some Medigap plans provide limited foreign travel emergency coverage, subject to plan rules and limits. Certain Medicare Advantage plans may also provide travel-related benefits, but coverage depends on the plan.

Anyone who spends significant time outside the United States should read the actual coverage documents rather than relying on general assumptions.

How Healthcare Usage Can Change the Comparison

The amount and type of healthcare you expect to use can materially affect how you evaluate Medicare Advantage and Medigap.

Someone who rarely visits doctors may focus heavily on monthly premiums, routine copayments, prescription costs, and available benefits.

Someone who sees several specialists every month may place greater importance on provider networks, referrals, prior authorization, and cost-sharing.

Someone managing a chronic condition may care particularly about access to specific specialists, hospitals, medications, and predictable medical expenses.

Someone who expects major medical treatment may want to understand the plan's maximum potential exposure, not simply its monthly premium.

This is why a plan comparison should be based on actual healthcare needs rather than a generic statement that one type of coverage is universally preferable.

Medicare Advantage vs. Medigap for People With Chronic Conditions

People with chronic conditions should pay particularly close attention to the details of any plan they consider.

Start with the doctors and facilities involved in your care. Verify that your specialists, hospital systems, laboratories, pharmacies, and other important providers are accessible under the plan.

Next, review the medications you currently take. A plan that looks inexpensive may not be financially attractive if your medications have unfavorable formulary placement or pharmacy requirements.

You should also examine prior authorization requirements and utilization rules for treatments you regularly receive.

With Medigap, the analysis is different. You would generally evaluate the standardized plan benefits, premium, insurer, Part D coverage, and your expected Original Medicare cost-sharing.

Health status can also matter when applying for Medigap outside protected enrollment periods because medical underwriting may apply unless a guaranteed-issue protection or state rule prevents it.

Medicare Advantage vs. Medigap for People With Limited Healthcare Use

People who use relatively little healthcare may have a different set of priorities.

A Medicare Advantage plan may have a low or zero additional monthly plan premium, while still providing an annual out-of-pocket limit and possibly additional benefits.

However, low premiums do not mean zero costs. You may still pay copayments, coinsurance, deductibles, and prescription expenses when you receive care.

A Medigap policy requires an additional premium, which can be a significant consideration for someone who rarely uses medical services.

The important question is therefore not simply "Which costs less?" A more useful question is: "How does each option distribute my healthcare costs between predictable monthly premiums and potentially variable costs when I use care?"

How to Compare Medicare Advantage Plans

Medicare Advantage plans should be compared at the individual plan level. Looking only at the company name or plan premium is not enough.

How to Compare Medigap Plans

Medigap shopping works differently because standardized plan letters make benefit comparison more straightforward.

If you are comparing the same Medigap plan letter from different insurers, the standardized benefits are generally the same. That means price becomes a major comparison point.

Medicare.gov recommends comparing prices from multiple companies because premiums can vary significantly between insurers.

You should also investigate how the insurer prices its policies, whether premiums have historically changed, whether the company sells policies in your area, and what customer-service resources are available.

Remember that Medigap is only one component of your overall Medicare strategy. You also need to consider your Part B premium and, if needed, prescription drug coverage.

Medigap Plan Letters: Why the Letter Matters

Medigap policies are generally standardized by letter. This means Plan G from one insurer is designed around the same standardized benefit structure as Plan G from another insurer, subject to applicable rules and availability.

This does not mean every Medigap plan letter is available everywhere or that every beneficiary can buy every plan. Availability can depend on location, eligibility, date of Medicare eligibility, and other factors.

Medicare.gov also notes that not everyone can purchase certain older Medigap plans, such as Plan C and Plan F, depending on when they first became eligible for Medicare.

Some Medigap plans also have different cost-sharing structures. For example, certain standardized plans may require the beneficiary to pay more of the cost before the plan begins paying, while others offer broader cost-sharing benefits.

The goal is not to memorize every plan letter. Instead, understand the standardized benefits of the plans available to you and compare their premiums and cost-sharing structures.

What Happens If You Have Medicare Advantage and Want Original Medicare?

Returning to Original Medicare can be possible during applicable enrollment periods or when a qualifying special circumstance applies.

However, the transition should be planned carefully. You need to understand when your Medicare Advantage coverage ends, when Original Medicare begins, whether you need Part D coverage, and whether you have a right to buy Medigap.

One of the most important mistakes to avoid is assuming that leaving Medicare Advantage automatically gives you guaranteed access to any Medigap policy you want.

Medicare.gov explains that outside the Medigap Open Enrollment Period, insurers generally may not have to sell you a policy unless you have guaranteed-issue rights or other applicable protections.

State law may provide additional rights, so beneficiaries should check with their state insurance department when appropriate.

Common Mistakes When Comparing Medicare Advantage and Medigap

Mistake 1: Comparing only the monthly premium

A low monthly premium does not tell you how much you could spend when receiving care. Review the full cost-sharing structure.

Mistake 2: Assuming every doctor who accepts Medicare accepts your Advantage plan

A provider can accept Medicare but not participate in a particular Medicare Advantage plan. Always check the plan's network.

Mistake 3: Ignoring prescriptions

Prescription costs can become a significant part of annual healthcare spending. Check formularies and pharmacy networks.

Mistake 4: Treating extra benefits as unlimited

Dental, vision, hearing, and other supplemental benefits may have annual limits, provider restrictions, eligibility rules, or specific covered services. Read the plan documents.

Mistake 5: Dropping Medigap without understanding future rights

Switching to Medicare Advantage can affect your future ability to purchase Medigap. Understand guaranteed-issue and trial rights before making the change.

Mistake 6: Confusing Medicare Open Enrollment with Medigap Open Enrollment

These are not the same thing. Medigap has a one-time six-month Open Enrollment Period beginning when you are 65 or older and enrolled in Part B.

Mistake 7: Ignoring travel requirements

If you regularly travel or live in more than one state, provider networks and geographic service areas deserve special attention.

Mistake 8: Assuming a $0 Medicare Advantage premium means $0 healthcare costs

Medicare Advantage plans can have $0 plan premiums, but cost-sharing still applies when you receive covered services.

Real-World Examples

Example 1: Someone who wants broad provider flexibility

Imagine a beneficiary who regularly travels between several states and has established relationships with multiple specialists. Provider flexibility may be a major consideration because Original Medicare generally allows access to any doctor or hospital that accepts Medicare.

If the person considers Medicare Advantage, they should carefully check the plan's network and travel rules before enrolling.

Example 2: Someone focused on monthly premiums

Another beneficiary may be highly focused on keeping monthly premiums low. Medicare Advantage plans can offer $0 additional plan premiums in some markets, although the beneficiary still generally pays the Part B premium and can face cost-sharing when using healthcare.

Example 3: Someone who wants predictable Medicare cost-sharing

A beneficiary may prefer Original Medicare with Medigap because the primary purpose of the Medigap policy is to help pay certain Medicare cost-sharing expenses.

This person would still need to account for Medigap premiums and potentially a separate prescription drug plan.

Example 4: Someone who values additional benefits

Another person may place significant value on supplemental dental, vision, hearing, transportation, or other benefits. In that situation, individual Medicare Advantage plans can be examined for the benefits actually offered in that person's service area.

The important lesson from all four examples is that the relevant comparison depends on the person's actual needs rather than a universal rule.

Medicare Advantage vs. Medigap and Medicaid

Medicare and Medicaid are separate programs, and some people qualify for both. If you are eligible for Medicaid, it can affect how you approach Medicare costs and supplemental coverage.

Medicaid may help with certain Medicare premiums and cost-sharing depending on the person's eligibility category and state rules.

People who have both Medicare and Medicaid are sometimes described as "dual eligible." Their Medicare coverage generally pays first for services covered by Medicare, while Medicaid may pay last according to applicable state rules.

If you are trying to understand the broader relationship between these programs, see the Provenzy guide: Medicare vs. Medicaid: What Are the Key Differences and Who Qualifies?

How Medicare Advantage and Medigap Fit Into the Larger Medicare System

It helps to think of Medicare as a system with several separate components.

Original Medicare consists of Part A and Part B. Part D provides outpatient prescription drug coverage through separate drug plans. Medigap supplements Original Medicare by helping with certain cost-sharing.

Medicare Advantage provides an alternative route. Instead of staying with Original Medicare as the primary way benefits are delivered, you enroll in a private Medicare Advantage plan that provides your Medicare Part A and Part B benefits and usually includes Part D.

This is why Medicare Advantage and Medigap should not be thought of as competing versions of the same insurance product. One changes how you receive Medicare benefits; the other supplements Original Medicare.

A Practical Medicare Advantage vs. Medigap Comparison Checklist

Before enrolling, use this checklist to make the comparison more concrete.

Questions to Ask Before Enrolling in Medicare Advantage

1. Are all of my doctors in the plan's network?
2. Is my preferred hospital in the network?
3. What are the costs for primary-care visits?
4. What are the costs for specialist visits?
5. What would I pay for outpatient procedures?
6. What would I pay for a hospital stay?
7. What is the annual out-of-pocket maximum?
8. Does the plan include prescription coverage?
9. Are all of my medications covered?
10. Does the plan require prior authorization for services I use?
11. Do I need referrals to see specialists?
12. What happens if I need routine care outside the service area?
13. What dental, vision, or hearing benefits are actually included?
14. What limitations apply to those additional benefits?

Questions to Ask Before Buying Medigap

1. Which Medigap plan letters are available in my state?
2. Am I still within my Medigap Open Enrollment Period?
3. Do I have guaranteed-issue rights?
4. How much is the monthly premium?
5. How does the insurer price this policy?
6. How have premiums changed historically?
7. Does the insurer offer the plan in my area?
8. What cost-sharing does the plan cover?
9. Do I need a separate Part D plan?
10. Does the policy offer foreign travel emergency benefits?
11. What happens if I later want to switch policies?
12. What happens if I decide to join Medicare Advantage later?

Can You Change Medicare Advantage Plans?

Medicare beneficiaries can have opportunities to change Medicare Advantage coverage during applicable Medicare enrollment periods. However, changing from one Medicare Advantage plan to another is different from switching from Medicare Advantage to Original Medicare and attempting to obtain Medigap.

When changing Medicare Advantage plans, review the new plan from the beginning rather than assuming your existing doctors, prescriptions, and benefits will carry over.

Provider networks and formularies can change between plans, even when different plans are offered by the same insurer.

What If Your Health Needs Change Later?

Healthcare needs are not fixed. A person who rarely sees doctors at age 65 may need significantly more specialist care several years later.

This is one reason the long-term implications of Medicare coverage choices deserve attention.

With Medicare Advantage, you should review the plan annually to determine whether your doctors, medications, network, cost-sharing, and supplemental benefits still meet your needs.

With Medigap, you should review premiums and plan availability and remain aware of any opportunities or restrictions related to changing policies.

A Medicare decision should therefore not be treated as something you research once and forget forever. Medicare plans, premiums, formularies, networks, benefits, and personal circumstances can change.

How to Think About the Decision Without Focusing Only on Price

A useful comparison starts with five questions.

1. How much provider freedom do I want?

If broad access to Medicare-participating providers is a major priority, understand how Original Medicare operates compared with the network rules of the Medicare Advantage plans available in your area.

2. How predictable do I want my healthcare expenses to be?

Medigap can help pay certain Original Medicare cost-sharing amounts. Medicare Advantage has plan-specific cost-sharing and an annual maximum for covered Medicare services.

3. How important are additional benefits?

If dental, vision, hearing, transportation, fitness, or other supplemental benefits matter, examine the exact benefits and limitations rather than relying on advertising language.

4. How complicated do I want prescription coverage to be?

Medicare Advantage commonly combines medical and drug coverage. Original Medicare with Medigap generally involves a separate Part D decision.

5. What are my future switching options?

Understand your Medigap enrollment rights before moving away from Original Medicare and Medigap.

How Article 6 Connects to This Guide

Medicare Advantage and Medigap are easier to understand when you first understand the difference between Medicare and Medicaid.

If you have not already read it, see: Medicare vs. Medicaid: What Are the Key Differences and Who Qualifies?

That guide explains who Medicare and Medicaid generally serve, how the programs differ, and how some people can qualify for both.

If you are also comparing health insurance after losing employer coverage, you may want to read: COBRA Insurance vs. Marketplace Plans: Which Is Better After Job Loss?

Frequently Asked Questions