Medigap vs. Medicare Advantage: Which Plan Is Right for You?

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 and B, and a Medigap policy acts as a second payer that covers your out-of-pocket costs 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, so you can see any doctor or specialist in the U.S. who accepts Medicare. For a full breakdown of what Original Medicare doesn't cover, see our companion guide.

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.

Important: You cannot have both Medigap and Medicare Advantage at the same time. They are mutually exclusive coverage options.

Cost Comparison: Premiums, Deductibles and 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 $165.85 per month at age 65 nationally in 2026, though rates in some carriers and states run as high as $220. Once you pay your premiums and meet the annual Part B deductible ($283 in 2026, up from $257 in 2025), 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 in 2026. For a deeper breakdown, see our complete Medicare Supplement cost guide.

Medicare Advantage Costs in 2026

The average Medicare Advantage premium is dropping to about $14/month in 2026 (down from $16.40 in 2025), with most enrollees still in $0-premium plans on top of the standard Part B premium ($202.90/month in 2026, up from $185 in 2025). 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 is capped at $9,250 for in-network care in 2026 (down $100 from $9,350 in 2025). The median MA in-network out-of-pocket maximum across plans climbed to about $5,900 for 2026.

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, since once enrolled your benefits don't change year to year
• People who want to avoid surprises, because 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. A Johns Hopkins Bloomberg School of Public Health analysis put the total facing forced disenrollment in 2026 at as many as 2.9 million people, roughly 1 in 10 of the MA market, following a sharp rise in insurers exiting the market. MA enrollment is also projected to drop by roughly 900,000 nationwide in 2026, the first decline in over a decade.

Major carriers driving the exits include UnitedHealth Group (with a complete pullout from Vermont and hundreds of thousands of affected enrollees), UCare Minnesota (which terminated all of its individual MA-PD plans covering nearly 150,000 members), Highmark Health (about 148,000 enrollees in Delaware, New York, Pennsylvania, and West Virginia), and Lifetime Healthcare (about 106,000 enrollees in New York).

The MA maximum out-of-pocket limit did drop slightly to $9,250 (from $9,350), but supplemental "extras" have been meaningfully scaled back for 2026 according to Better Medicare Alliance's plan data:

• OTC allowances offered by 66% of individual MA plans in 2026 vs. 73% in 2025
• Meal benefits offered by 58% of individual plans vs. 65% in 2025
• Transportation to medical appointments offered by 23% of individual plans vs. 29% in 2025
• Fitness benefits offered by 93% of plans vs. 96% in 2025
• Nutrition benefits offered by 25% of plans vs. 30% in 2025

Dental (98%), telehealth (99%), and hearing benefits remain nearly universal in MA plans and held steady from 2025 to 2026, but the high-dollar flex-card perks that drove many enrollments in recent years are clearly shrinking, with Wakely's analysis showing plans on average reduced flex-card and dental benefit value even where the benefit itself remained. CMS also ended the Value-Based Insurance Design (VBID) supplemental benefit pilot on January 1, 2026, eliminating enhanced food, transportation, and chronic care supports that had reached more than 7 million MA enrollees. On top of that, CMS tightened the rules around Special Supplemental Benefits for the Chronically Ill, ending coverage for things like funeral planning, life insurance, and certain unhealthy foods in 2026.

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. For a full walkthrough, see our step-by-step switching guide.

When You Can Switch

• Annual Enrollment Period (AEP): October 15 through December 7 (coverage effective January 1)
• Medicare Advantage Open Enrollment: January 1 through 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 (this applies to the up to 2.9 million enrollees affected by 2026 plan exits)

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 at 65 and switch back within 12 months (the "trial right")
• You dropped a Medigap policy for the first time to try MA and want to return within 12 months
• Certain state-specific protections (states like NY, CT, ME, and MA have broader rights, and the birthday rule states for 2026 now include Delaware, Indiana, and West Virginia)

If none of these exceptions apply, you'll need to apply and hope you can qualify medically. For this reason, explore the best Medicare supplement plans for 2026 early, before committing to Medicare Advantage long-term. You may also want to weigh lower-premium alternatives like Plan N coverage (averaging about $123/month at age 65) or High-Deductible Plan G if standard Plan G feels too expensive.

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 (averaging just $14/month in 2026, and many plans are $0 beyond Part B), but you pay copays and coinsurance up to $9,250 out-of-pocket for in-network care. Medigap Plan G has higher premiums (around $165.85/month at age 65) but covers nearly all out-of-pocket costs after you meet the $283 Part B deductible. If you need frequent care or have chronic conditions, 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, which averages $34.50/month in 2026 with an out-of-pocket cap of $2,100 thanks to the Inflation Reduction Act. 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 through December 7) or the Medicare Advantage Open Enrollment Period (January 1 through March 31). However, unless you qualify for a guaranteed-issue exception (such as your plan being terminated, or you're within 12 months of first enrolling in MA at 65), you will need to pass medical underwriting. With up to 2.9 million enrollees facing forced disenrollment in 2026, many will trigger a Special Enrollment Period and qualify for guaranteed-issue Medigap rights.

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 and Plan F) 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.