How Each Plan Works
When you're first enrolling in Medicare, one of the most important decisions you'll make is how to cover what Original Medicare (Parts A & B) doesn't pay for. Two fundamentally different paths exist — and confusing them is one of the most common and costly mistakes seniors make.
Medigap (Medicare Supplement Insurance) works alongside Original Medicare. You keep your full Medicare Parts A & B, and a Medigap policy acts as a second payer that covers your out-of-pocket costs — things like deductibles, copays, and coinsurance. Plans are standardized and lettered (A through N), so a Plan G from one insurer covers the exact same benefits as Plan G from another. There are no provider networks — you can see any doctor or specialist in the U.S. who accepts Medicare.
Medicare Advantage (Part C), by contrast, replaces Original Medicare entirely. A private insurer contracts with Medicare to deliver your benefits through their plan, typically via an HMO or PPO network. These plans often bundle prescription drug coverage and extras like dental, vision, and hearing — but they come with provider networks, referral requirements, and prior authorization rules that can limit your access to care.
Medigap
- Works alongside Original Medicare
- Any doctor that accepts Medicare
- No referrals or prior auth needed
- No dental, vision, or hearing benefits
- Requires separate Part D plan
Medicare Advantage
- Replaces Original Medicare
- Must use in-network providers
- Prior auth often required
- Often includes dental, vision, hearing
- Drug coverage usually bundled
Important: You cannot have both Medigap and Medicare Advantage at the same time. They are mutually exclusive coverage options.
Cost Comparison: Premiums, Deductibles & Out-of-Pocket
Cost is often the deciding factor — but the "cheaper" option depends entirely on how much healthcare you use.
Medigap Costs in 2026
Medigap premiums vary based on your age, location, gender, and the insurer you choose. The most popular option, Plan G, averages around $215/month — but once you pay your premiums and meet the annual Part B deductible ($283 in 2026), Medicare and your Medigap plan cover the rest of your Medicare-approved services. There is effectively no out-of-pocket maximum to worry about because covered costs are already taken care of. You'll also need a standalone Part D plan for prescription drugs, which averages around $34.50/month.
Medicare Advantage Costs in 2026
Medicare Advantage plans average just $14/month in additional premium — and many plans charge $0 beyond your standard Part B premium ($202.90/month). However, you pay copays and coinsurance each time you use services, and costs accumulate until you hit the plan's annual out-of-pocket maximum, which sits at $9,250 for in-network care in 2026 (with a median around $5,900 across plans).
| Cost Factor | Medigap (Plan G) | Medicare Advantage |
|---|---|---|
| Avg. Monthly Premium | ~$215/month | ~$14/month (many $0) |
| Annual Deductible | $283 (Part B only) | Varies by plan |
| Out-of-Pocket Max | $0 for covered services | Up to $9,250 (in-network) |
| Drug Coverage | Separate Part D (~$34.50/mo) | Usually bundled |
| Dental/Vision/Hearing | Not included | Often included |
Medicare Savings Tip
Who Each Plan Is Best For
The right choice isn't universal — it depends on your health, lifestyle, and priorities.
Medigap Is Best For:
- Frequent travelers or snowbirds who need coverage anywhere in the U.S. without worrying about network restrictions
- Seniors with chronic conditions who see specialists regularly and need predictable costs
- Those who value simplicity — once enrolled, your benefits don't change year to year
- People who want to avoid surprises — Medigap eliminates most out-of-pocket variability
Medicare Advantage Is Best For:
- Budget-conscious seniors who want lower monthly premiums and don't use much care
- Those who want extra benefits like dental, vision, hearing, and fitness programs included
- People who stay local and are comfortable using an in-network provider network
- Enrollees who need drug coverage bundled into a single, convenient plan
The 2026 Shift: Why Medigap Is Gaining Ground
In 2026, Medicare Advantage is facing significant headwinds that are making Medigap more attractive by comparison. Plan availability has dropped from an average of 36 MA-PD options per beneficiary in 2024 to just 32 in 2026. Over 2.6 million enrollees were impacted by plan terminations from 2025 plans. Supplemental benefits have been scaled back across the board — fewer plans are offering over-the-counter allowances (down to 66% from 73%), meal benefits (57% vs. 65%), transportation coverage (24% vs. 30%), and remote access technologies (48% vs. 53%). Additionally, a major CMS pilot program providing food assistance and lower drug costs ended January 1, 2026, affecting more than 7 million enrollees.
Switching from MA to Medigap Is Not Easy
How to Switch from Medicare Advantage to Medigap
Switching from Medicare Advantage back to Medigap is possible, but it comes with real underwriting challenges that every senior should understand before making the move.
When You Can Switch
- Annual Enrollment Period (AEP): October 15 – December 7 (coverage effective January 1)
- Medicare Advantage Open Enrollment: January 1 – March 31 (change to Original Medicare only)
- Special Enrollment Periods: Triggered by qualifying events such as moving out of a plan's service area or your plan being discontinued
The Underwriting Problem
Unlike your initial Medigap Open Enrollment Period (6 months from your Part B start date at 65), switching from Medicare Advantage later in life generally requires you to pass medical underwriting. Insurers can review your health history, current prescriptions, and pre-existing conditions — and they can deny your application or charge significantly higher premiums.
Guaranteed-issue exceptions (where underwriting is waived) include:
- Your Medicare Advantage plan is terminated or leaves your service area
- You joined Medicare Advantage when first eligible and switch back within 12 months
If neither exception applies, you'll need to apply and hope you can qualify medically. For this reason, explore your best Medicare supplement plan options early — before committing to Medicare Advantage long-term.
Pros
- No network restrictions — any Medicare-accepting provider
- Predictable costs — no surprise out-of-pocket bills
- Coverage doesn't change year to year
- Ideal for travelers and those with complex needs
Cons
- Higher monthly premiums
- No extra benefits (dental, vision, hearing)
- Requires a separate Part D plan
- Harder to switch back to if you start with Medicare Advantage
Frequently Asked Questions
Can I have both Medigap and Medicare Advantage at the same time?
No — this is one of the most common misconceptions about Medicare. Medigap is designed to supplement Original Medicare, while Medicare Advantage replaces it entirely. Because you cannot be on both Original Medicare and Medicare Advantage simultaneously, you also cannot have a Medigap policy active at the same time as a Medicare Advantage plan. You must choose one path or the other.
Is Medigap or Medicare Advantage cheaper in 2026?
It depends on how much healthcare you use. Medicare Advantage has lower monthly premiums (often $0 beyond Part B), but you pay copays and coinsurance at the point of service — up to $9,250 out-of-pocket in 2026. Medigap has higher premiums (around $215/month for Plan G) but covers most out-of-pocket costs after you meet the $283 Part B deductible. If you need frequent care, Medigap often works out to be less expensive overall.
Does Medigap cover prescription drugs?
No. Medigap policies do not include prescription drug coverage. If you choose Medigap, you will need to purchase a separate Medicare Part D plan to cover your medications. Most Medicare Advantage plans, on the other hand, bundle drug coverage directly into the plan — making it a more convenient (though not always cheaper) option for those with significant medication needs.
What happens if I want to switch from Medicare Advantage to Medigap?
You can switch during the Annual Enrollment Period (October 15 – December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31). However, unless you qualify for a guaranteed-issue exception — such as your plan being terminated — you will need to pass medical underwriting. This means insurers can deny your application or charge higher premiums based on your health history, making it critical to choose your original plan wisely.
Which plan is better for traveling seniors?
Medigap is the clear winner for seniors who travel frequently, whether domestically or internationally. Because Medigap works with Original Medicare and has no provider networks, you can see any doctor or hospital in the U.S. that accepts Medicare — without worrying about being out-of-network. Some Medigap plans (like Plan G) also include foreign travel emergency coverage. Medicare Advantage plans typically restrict you to regional networks, making them a poor fit for frequent travelers or snowbirds.