Medicare Advantage vs. Medicare Supplement (Medigap)
Both build on top of Original Medicare, but they work in completely different ways. Here's the plain-English breakdown — what each one is, what it costs in 2026, and how to know which fits your situation.
Medicare Advantage
An all-in-one private plan that replaces Parts A & B (and usually D) with one card, a provider network, and a yearly out-of-pocket cap — often for a low or $0 premium.
Medigap
A standardized private policy that fills the "gaps" left by Original Medicare — deductibles, copays, coinsurance — while you keep Original Medicare and see any provider who accepts it, nationwide.
How They Compare
Same starting point — you must already have Medicare Part A & B — two very different paths from there.
| Medicare Advantage (Part C) | Medigap (Medicare Supplement) | |
|---|---|---|
| How it works | A private plan replaces Original Medicare as your primary coverage, and usually bundles in drug coverage and extras. | A private policy works alongside Original Medicare, paying some or all of the costs Medicare doesn't. |
| Provider access | Usually a network (HMO or PPO) — you may need referrals or pay more out-of-network. | See any doctor or hospital nationwide that accepts Medicare — no networks, no referrals. |
| 2026 monthly premium | Average $14–$15/month supplemental premium; about 3 in 4 enrollees pay $0 beyond the Part B premium. | No CMS-set average — premiums are set by each insurer based on age, location and plan letter, typically $100–$300+/month. |
| 2026 out-of-pocket cap | Required by law. Plans may charge up to $9,250 in-network; the 2026 enrollment-weighted average is about $5,421. | Original Medicare itself still has no out-of-pocket cap — but high-coverage Medigap plans (like Plan G) pay nearly all the gaps, so your real exposure is very low. |
| Prescription drugs | Usually bundled in (MA-PD plans) under the 2026 $2,100 Part D cap. | Not included — you pair it with a stand-alone Part D plan (also under the $2,100 cap). |
| Extra benefits | Many plans add dental, vision, hearing, and fitness benefits not covered by Original Medicare. | Standardized medical gap-filling only — no extra benefits built in. |
| Enrollment rules | Guaranteed issue each year during Open Enrollment (Oct 15–Dec 7) — no health questions. | Guaranteed issue only during your one-time 6-month Medigap Open Enrollment window; after that, insurers can usually medically underwrite you in most states. |
| Best fit if you... | Want the lowest possible premium, are comfortable with a network, and like bundled extras like dental and vision. | Travel often, want maximum provider freedom, and prefer predictable costs over the lowest possible premium. |
Three Questions That Usually Decide It
How often do you travel?
Snowbirds and frequent travelers usually lean Medigap for nationwide, network-free access. If you stay local year-round, an Advantage network may never be an issue.
Premium now, or costs later?
Advantage plans trade a lower monthly premium for cost-sharing if you get sick. Medigap trades a higher monthly premium for very predictable costs later.
Do you want extras bundled in?
If dental, vision, hearing or fitness benefits matter to you, Advantage plans usually include them. With Medigap, you'd shop for those separately.
Switching Between Them Isn't Always Easy
This is the part people are most often surprised by — and exactly what we walk through with every client.
Usually straightforward
You can drop a Medigap policy and enroll in Medicare Advantage during Open Enrollment (Oct 15–Dec 7) without health questions.
Can require medical underwriting
Outside your one-time Medigap Open Enrollment window (or a qualifying Special Enrollment Period), an insurer can review your health and may charge more — or decline coverage — in most states.
Let's find your fit — not just a plan.
We'll walk through your doctors, prescriptions, travel habits and budget, then show you exactly how Advantage and Medigap options compare where you live.