Medicare Advantage vs Medigap: Which Should You Choose?
Short answer
Medigap (also called Medicare Supplement) is a private policy that sits alongside Original Medicare and pays some or all of the deductibles, copays and coinsurance that Original Medicare leaves you to pay. It has no network, works with any provider that accepts Medicare, and charges its own monthly premium on top of your Part B premium. It does not include prescription drug coverage, so you add a separate Part D plan.
Medicare Advantage (Part C) is a private plan that replaces Original Medicare. It normally uses a provider network, usually includes drug coverage, often adds dental, vision and hearing benefits, frequently charges a $0 plan premium, and must cap your annual out-of-pocket costs.
You cannot have both. It is against the law for someone to sell you a Medigap policy while you are enrolled in a Medicare Advantage plan. The practical question is not which is better, but which trade you prefer: pay more every month for predictability and provider freedom, or pay less every month and more when you use care.
Side-by-side comparison
| Feature | Medigap + Original Medicare | Medicare Advantage |
|---|---|---|
| What it does | Adds to Original Medicare, paying your share of costs | Replaces Original Medicare with a private plan |
| Provider choice | Any provider in the U.S. that accepts Medicare; no referrals | Usually a network; HMOs often need referrals and out-of-network care can cost much more |
| Monthly premium | Part B premium plus a Medigap premium plus a Part D premium | Part B premium plus the plan premium, which is often $0 |
| Costs when you use care | Very low or none, depending on the plan letter | Copays and coinsurance for most services |
| Out-of-pocket maximum | Not applicable — the policy is designed to cover the gaps | Required annual cap on in-network costs |
| Prescription drugs | Not included; add a separate Part D plan | Usually included |
| Dental, vision, hearing | Not included | Frequently included, though the amount of coverage varies widely |
| Prior authorization | Rare | Common for higher-cost services |
| Travel within the U.S. | Works anywhere Medicare is accepted | Usually tied to a service area; emergencies covered away from home |
| Can you be turned down? | Yes, outside your guaranteed-issue window — see below | No. Advantage plans cannot reject you for health reasons during a valid enrollment period |
How Medigap plans are labelled
Medigap policies are standardised by letter. A Plan G from one insurer covers exactly the same benefits as a Plan G from another — only the price, the service and the rate history differ. That makes them unusually easy to compare, and it means shopping on price is rational in a way it rarely is in insurance.
- Plan G is the most comprehensive option available to people who became eligible for Medicare on or after January 1, 2020. It covers everything except the Part B deductible.
- Plan N costs less than Plan G and covers slightly less, with small copays for some office and emergency visits.
- Plan F is the most comprehensive of all, but is closed to anyone who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date you may still be able to buy it.
- Massachusetts, Minnesota and Wisconsin standardise their policies differently from the rest of the country.
Because the benefits are fixed by law, the meaningful differences between insurers are premium, how sharply they raise rates over time, and how they price by age. Ask about rate history, not just today's premium.
Who tends to choose which
Medigap tends to suit people who:
- Want to see any doctor or hospital that accepts Medicare, including out-of-state specialists and major treatment centres
- Travel, spend part of the year in another state, or split time between homes
- Are managing a serious or ongoing condition and want costs to be predictable when they use a lot of care
- Would rather pay a known amount every month than face variable bills
- Are inside their guaranteed-issue window and can buy without underwriting
Medicare Advantage tends to suit people who:
- Want the lowest monthly outlay and are comfortable paying copays when they use care
- Already use doctors who are in the plan's network
- Want drug, dental, vision and hearing benefits bundled into one plan and one card
- Stay mostly in one area during the year
- Are outside the Medigap guaranteed-issue window and would face underwriting
- Are in good health and prefer a hard annual cap over paying premiums for coverage they may not use
The cost trade in plain terms
Medigap generally means a higher, steadier monthly cost and very little to pay when you receive care. Medicare Advantage generally means a lower monthly cost and more to pay as you go, up to the plan's annual limit.
That means the same two plans can produce opposite conclusions for two different people. Someone who sees a doctor twice a year may spend less overall with Medicare Advantage. Someone facing surgery, ongoing specialist care or a long hospital stay may spend less overall with Medigap, and will know in advance roughly what it will cost.
The comparison people get wrong is judging by premium alone. Add the premium you would pay for a year to the costs you would realistically incur in that year, under both options, and compare the totals.
Frequently asked questions
Can I have Medicare Advantage and Medigap at the same time?
No. Medigap is designed to work only with Original Medicare. It is illegal for anyone to sell you a Medigap policy while you are enrolled in a Medicare Advantage plan, unless you are in the process of leaving that plan. If you have both, the Medigap policy pays nothing towards your Advantage plan's costs.
Can I switch from Medicare Advantage to Medigap later?
You can leave a Medicare Advantage plan during a valid enrollment period, but buying a Medigap policy afterwards is a separate question. Outside your guaranteed-issue window, insurers in most states may use medical underwriting and can decline you or charge more because of your health. Some states grant broader rights, and certain circumstances create a guaranteed-issue right. Check your state's rules before you rely on being able to switch.
Does Medigap cover prescription drugs?
No. Medigap policies sold today do not include drug coverage. You add a separate Part D plan. Going without creditable drug coverage after you first become eligible can create a permanent late enrollment penalty.
Is Plan F still available?
Only to people who became eligible for Medicare before January 1, 2020. If you became eligible on or after that date, Plan G is generally the most comprehensive option available to you.
Are all Plan G policies the same?
The benefits are identical by law, whichever insurer sells it. The premium, the rate increase history and the service are not. Because the coverage is standardised, comparing price and rate stability between insurers is a sensible way to choose.
Which is cheaper, Medigap or Medicare Advantage?
Medicare Advantage almost always costs less per month. Whether it costs less per year depends entirely on how much care you use. Compare a full year of premiums plus expected costs under both, rather than comparing monthly premiums alone.
Compare Medigap and Advantage plans where you live
Tell us a little about yourself and a licensed insurance agent can walk you through both options in your area, including whether your guaranteed-issue window is still open. There is no cost and no obligation.
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Related guides
- Medicare Advantage vs Original Medicare — the underlying choice this one builds on
- Medicare enrollment periods and deadlines — when you can actually make a change
- Turning 65: how to sign up for Medicare — where your Medigap window begins