Medicare Advantage and Medigap serve different purposes. Medicare Advantage is a private-plan way to receive your Part A and Part B benefits. Medigap supplements Original Medicare by helping pay certain out-of-pocket costs. Medigap cannot pay the deductibles, copayments or premiums of Medicare Advantage.
Compare the coverage structure
| Question | Medicare Advantage | Original Medicare with Medigap |
|---|---|---|
| Who provides the Medicare benefits? | A private plan approved by Medicare administers Part A and Part B benefits. | Original Medicare provides Parts A and B; Medigap supplements covered costs. |
| How are providers selected? | Network and referral rules depend on the plan type. | You can generally use providers who take Medicare. Medicare SELECT policies can add network requirements for full supplemental benefits. |
| What premiums apply? | You keep paying Part B and any plan premium. A $0 plan premium does not mean all care is free. | You pay Part B and the Medigap premium, plus any other coverage premiums. |
| What about extra benefits? | Some plans include benefits such as dental or vision, with plan-specific limits. | Standard Medigap benefits generally exclude routine dental and vision care. |
| How is Part D arranged? | Usually included, but check the specific plan. | Usually obtained through a separate Part D plan. |
Compare the cost of a year, not only the premium
Medicare Advantage plans have an annual limit on your out-of-pocket costs for covered Part A and Part B services. Check which expenses count toward it and any separate in-network and combined limits. Original Medicare has no annual out-of-pocket limit by itself; a Medigap policy helps with specified costs, with benefits depending on its letter.
Estimate premiums, expected appointments, hospital care and other cost-sharing together. Neither route is automatically the lowest-cost choice for every person. Check how each arrangement works with employer, retiree, Medicaid or other coverage before changing it.
Provider access and travel
Check the actual doctors, hospitals and service area of a Medicare Advantage plan. HMO and PPO rules differ, and out-of-network care may cost more or not be covered outside applicable exceptions. With Original Medicare and Medigap, confirm that the provider accepts Medicare and ask about assignment. Some Medigap plans have a limited foreign-travel emergency benefit; it is not comprehensive travel insurance.
Do not overlook future enrollment rights
You need both Parts A and B to join Medicare Advantage. Plan changes must use an allowed enrollment period. Medigap has a separate six-month federal open enrollment window for people 65 or older with Part B, plus certain guaranteed issue and state rights. Leaving Medicare Advantage does not automatically guarantee acceptance into every Medigap policy.
If you are considering a switch, confirm the new coverage, start date and any medical underwriting before canceling existing coverage. An insurance agent can explain available policies; your personal rights depend on the specific enrollment situation and state.
Five questions for a comparison appointment
- Are my doctors and preferred hospitals available?
- What could I pay in a routine year and a year with more care?
- How are Part D and any extra benefits handled?
- What changes when I travel or move?
- What would be required if I later want to switch coverage?
Related coverage questions
- What Is Medigap? Benefits, Costs and Enrollment
- How to Compare Medigap Policies
- Medigap Comparison Chart: Benefits and 2026 Cost Limits