Medicare Advantage vs. Medigap: What’s the Difference?

“Decisions are the hardest thing to make, especially when it’s a choice between where you should be and where you want to be.” – Unknown

When it comes to Medicare, one of the most common decisions people face is whether to choose Medicare Advantage (Part C) or a Medigap (Medicare Supplement) plan. Both options work with Original Medicare, but they serve different purposes — and the right choice depends on your healthcare needs, lifestyle, and budget.

What Is Medicare Advantage?

Medicare Advantage (Part C) plans are offered by private insurance companies and bundle your Part A (hospital) and Part B (medical) coverage into one plan. Many also include prescription drug coverage (Part D) and extra benefits like dental, vision, hearing, gym memberships, or transportation.

• Pros: Often lower monthly premiums, extra benefits included, one ID card for all services.

• Cons: Limited provider networks, copays and coinsurance apply, plan benefits can change each year.

What Is Medigap?

Medigap (Medicare Supplement) plans are also offered by private insurance companies, but they work differently. Instead of replacing your Original Medicare, they help pay for the out-of-pocket costs Medicare doesn’t cover, such as deductibles, copays, and coinsurance.

• Pros: Access to any doctor or hospital nationwide that accepts Medicare, predictable out-of-pocket costs, stable benefits year after year.

• Cons: Higher monthly premiums, doesn’t include prescription drug coverage (Part D must be purchased separately), fewer extra perks like dental or vision.

Key Differences at a Glance

• Network: Advantage = limited provider networks; Medigap = nationwide access.

• Costs: Advantage = lower premiums but higher copays/coinsurance; Medigap = higher premiums but lower out-of-pocket costs.

• Extras: Advantage often includes dental, vision, and wellness perks; Medigap generally does not.

• Flexibility: Advantage benefits and costs can change yearly; Medigap offers more stability.

Which One Is Right for You?

• Choose Medicare Advantage if you want lower monthly premiums, don’t mind provider networks, and like the convenience of extra benefits.

• Choose Medigap if you travel often, want freedom to see any doctor, and prefer predictable out-of-pocket costs.

Final Thoughts

There’s no one-size-fits-all answer — the right plan depends on your lifestyle, health needs, and budget. The good news is you don’t have to figure it out alone. As your local licensed insurance agent, I’ll walk you through your options, compare plans side by side, and help you choose the coverage that fits your life today and tomorrow.

FAQs: Medicare Advantage vs. Medigap

1. Can I have both Medicare Advantage and Medigap?
No. You must choose one or the other. Medigap only works with Original Medicare, not with Medicare Advantage plans.

2. Which is cheaper: Medicare Advantage or Medigap?
Medicare Advantage usually has lower monthly premiums but higher copays and coinsurance. Medigap has higher premiums but fewer out-of-pocket costs when you use care.

3. Do Medigap plans include prescription drug coverage?
No. If you choose Medigap, you’ll need a separate Part D plan for prescription drug coverage. Many Medicare Advantage plans already include it.

4. Can I switch from Medicare Advantage to Medigap later?
Yes, but it’s not always guaranteed. After your initial enrollment, Medigap companies may require medical underwriting, meaning they can deny coverage based on health conditions.

5. Which option is better for people who travel a lot?
Medigap is usually better for frequent travelers because it lets you see any doctor or hospital in the U.S. that accepts Medicare. Some Medigap plans also offer limited foreign travel emergency coverage.

6. What’s the biggest difference between the two?
Medicare Advantage combines coverage and extras in one plan but limits you to a provider network. Medigap costs more each month but offers broader access and more predictable expenses.