Original Medicare, with optional additional coverage
Original Medicare is Part A and Part B. You can generally use any U.S. doctor or hospital that accepts Medicare. It does not have an annual out-of-pocket limit for covered services on its own.
You may add a stand-alone Part D plan for drugs and a Medigap policy to help with specified remaining costs. Medigap availability and enrollment protections depend on your circumstances and state.
Medicare Advantage (Part C)
A Medicare Advantage plan provides Part A/B benefits through a private insurer approved by Medicare. Most include Part D and some offer extra benefits. Networks, prior authorization, costs and covered extras differ.
You generally continue paying the Part B premium. A low additional plan premium does not tell you the total cost of care.
Compare the main differences
| Feature | Medicare Advantage | Original Medicare + Medigap |
|---|---|---|
| How coverage works | A private plan provides your Part A and Part B benefits. | Original Medicare pays first; a Medigap policy helps with specified remaining costs. |
| Doctors and hospitals | Network, referral and prior-authorization rules depend on the plan. Check each doctor and facility. | Usually any provider in the U.S. that accepts Medicare. Medicare SELECT policies can have network requirements. |
| Prescription drugs | Most plans include Part D; verify each medication and pharmacy. | New Medigap policies do not include Part D. A separate drug plan may be needed. |
| Monthly premiums | Part B still applies; the plan may charge another premium. A $0 plan premium does not mean $0 total cost. | Part B, Medigap and any separate Part D premiums apply. |
| Medical out-of-pocket costs | A yearly limit applies to covered Part A/B services; network and other rules affect the limit. | Original Medicare alone has no annual limit. Medigap pays the benefits specified by its plan letter. |
| Dental, vision and hearing | Some plans include extra benefits with limits, networks and eligibility conditions. | Medigap generally does not cover routine dental, vision or hearing services. |
| Travel and moving | Emergency and urgent care rules differ from routine care. Foreign emergency benefits are plan-specific. | Medicare works nationwide with participating providers; certain Medigap plans include limited foreign travel emergency benefits. |
| Changing coverage later | You need an applicable enrollment period. | Outside protected enrollment rights, medical underwriting may apply. State rules differ. |
How does other insurance affect your choice?
Employer or union coverage, Medicaid, VA benefits, TRICARE and other insurance may coordinate with Medicare in different ways. Joining a plan may affect existing benefits for you or your dependents. Ask the benefits administrator before changing anything.
Some people receive help through Medicare Savings Programs or Extra Help. Eligibility for assistance and eligibility for a specific plan are separate questions.
Make a decision with the details in front of you
- Verify every doctor and hospital with the specific plan and provider.
- Review prescriptions by name, dosage, frequency and pharmacy.
- Compare annual costs, not just monthly premiums.
- Read exclusions, network rules and the Summary of Benefits.
- Confirm your enrollment period and coverage start date.
You can enroll directly through an insurer, through Medicare.gov where available, or with help from a Licensed Insurance Agent. We are an independent agency, not a government marketplace.