Medicare Advantage vs. Medigap
Compare complete coverage structures—not isolated premiums or benefits.
Two incompatible structures
Advantage is a private Medicare-approved way to receive Part A and Part B benefits, usually with Part D. Medigap is a separate policy that helps pay eligible Original Medicare cost sharing after Medicare processes a claim. Medigap does not work with Advantage and cannot pay its copays. Under Original Medicare, a standalone Part D plan is a separate drug decision.
Official source: Medicare: Original versus Advantage ↗ · Medicare: Medicare Advantage guide ↗ · Medicare: Buying Medigap ↗
Compare provider access
Original Medicare generally lets you use a doctor or hospital that accepts Medicare throughout the United States. Advantage nonemergency care can depend on the plan network, service area, referrals and authorizations. HMO-POS and PPO structures may cover certain out-of-network care at higher cost. List the providers and facilities you actually use and confirm each under the exact plan before comparing an advertised premium.
Official source: Medicare: Original versus Advantage ↗ · Medicare: Compare plan types ↗ · Medicare: Provider network fact sheet ↗
Run both cost models
Original Medicare has no general annual limit on covered Part A/B cost sharing without other protection; a Medigap premium may buy coverage of specified gaps. Advantage has an annual limit for covered medical Part A/B costs but may have its own premium and plan rules. In 2026 most people also pay the $202.90 Part B premium. Include Part D spending separately and compare routine and high-use years.
Official source: Medicare: Original versus Advantage ↗ · Medicare: Medicare Advantage guide ↗ · Medicare: 2026 costs ↗
Treat future switching rights as a risk
A person generally has a six-month federal Medigap open-enrollment window beginning when at least 65 and enrolled in Part B. Other guaranteed-issue rights can arise from specific events, but leaving Advantage later does not always make a desired Medigap policy available without underwriting. Get the actual state rule and deadlines before relinquishing existing Medigap protection.
Official source: Medicare: Buying Medigap ↗ · Medicare: Original versus Advantage ↗
Compare one person and one plan year
Use the same ZIP code, physicians, hospital, prescriptions, pharmacy, travel needs and budget in both paths. Verify the plan’s current Evidence of Coverage and a comparable Medigap letter, carrier rate, Part D option and enrollment eligibility. Do not compare only an Advantage monthly premium to a Medigap monthly premium without adding medical and drug costs.
Official source: Medicare: Compare plans ↗ · Medicare: Evidence of Coverage ↗ · Medicare: Original versus Advantage ↗