Health Insurance Education Center
Two very different approaches to addressing the gaps in Original Medicare. Understanding what Original Medicare actually covers — and what it does not — is the essential starting point for this decision.
Plan Type Overview
A Medicare Advantage plan is an all-in-one alternative to Original Medicare. A private insurance company approved by Medicare delivers your Part A and Part B benefits through the plan — often bundled with Part D drug coverage and additional benefits that vary by plan and location.
A Medicare Supplement (Medigap) policy is secondary insurance that works alongside Original Medicare. It does not replace Medicare — it pays after Medicare pays, covering some or all of the out-of-pocket gaps such as deductibles, coinsurance, and copayments. Plans are standardized by letter.
Side-by-Side Comparison · 2026
| Feature | Medicare Advantage (Part C) | Medicare Supplement (Medigap) |
|---|---|---|
| How it works | Replaces Original Medicare through a private plan approved by Medicare | Secondary insurance alongside Original Medicare — does not replace it |
| Monthly premium | Varies by plan, carrier, and location. Contact me for plan options available in your county. | Varies by plan letter, insurer, age, and location. Generally higher monthly premiums than many MA plans. |
| Part B premium | Still required regardless of MA enrollment | Still required regardless of Medigap enrollment |
| Provider network | Must use plan's network (HMO/PPO) for covered care in most cases | Any Medicare-accepting provider nationwide — no network restrictions |
| Referrals for specialists | Required on HMO-type plans | Never required |
| Out-of-pocket maximum | All MA plans are required to have an out-of-pocket cap; specific amounts vary by plan | Varies by plan letter; some plans cover most costs after the applicable deductible |
| Prescription drugs | Part D often bundled in many plans — varies by plan | Not included — must purchase a separate Part D plan |
| Dental, vision, hearing | May be included as additional benefits depending on the specific plan and location | Not included in standardized Medigap coverage |
| Cost predictability | Copays per visit vary; costs can accumulate with more frequent care use | More predictable — most costs addressed after meeting the applicable deductible |
| Annual plan changes | Benefits, premiums, and networks can change each year upon contract renewal | Standardized letter benefits stay consistent; premiums may change |
| Travel / out-of-area | Emergency coverage available nationally; routine care generally restricted to local network | Works with any Medicare-accepting provider anywhere in the U.S. |
Medicare Supplement Plans
In most states, Medigap plans are standardized by the federal government and identified by letters A through N. Every insurer offering a given plan letter must provide the same core benefits — the primary difference between carriers is price and customer service. When comparing plans of the same letter, you are comparing prices, not benefits.
Core benefits only. Covers Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted. Most limited of the standardized plans.
Plan A benefits plus coverage of the Part A hospital deductible. Modest upgrade from Plan A with added inpatient protection.
Comprehensive coverage — addresses most out-of-pocket costs except the annual Part B deductible. Frequently selected by new Medicare enrollees. Premium and availability vary by insurer and location.
Lower premium than Plan G with modest cost-sharing at time of service (office visits and ER). Offers a balance between monthly cost and coverage. Suitable for those comfortable with some cost-sharing.
Most comprehensive — covers the Part B deductible as well. Only available to beneficiaries whose Medicare eligibility date is before January 1, 2020.
Similar to Plan F. Also restricted to beneficiaries with a Medicare eligibility date before January 1, 2020.
Covers Part A deductible, coinsurance, and skilled nursing facility care. Does not cover the Part B deductible or Part B excess charges.
Pays 50% of cost-sharing with a lower annual out-of-pocket limit. Lower monthly premium option for those comfortable with more cost-sharing at point of service.
Pays 75% of cost-sharing. Mid-tier option between K and fuller coverage plans. Lower premium with shared costs at time of service.
Covers 50% of the Part A deductible. Lower monthly premiums in exchange for partial deductible responsibility. Less common but available in most states.
Making the Right Choice
Individual circumstances vary widely. The scenarios below are illustrative examples only — not recommendations for any specific individual. Your specific health needs, financial situation, preferred providers, and county of residence all affect which option may fit best. These examples should not be relied upon as personal advice.
A beneficiary on a fixed income who is generally healthy may find that a Medicare Advantage plan offers a lower monthly premium than a Medigap plan. Out-of-pocket costs occur at time of service through copays; the plan's required out-of-pocket maximum provides a cap on annual exposure. Plans vary — review the specific plan's cost-sharing before enrolling.
Actual premiums and cost-sharing vary by plan and county. Network restrictions apply. Review the plan's Evidence of Coverage before enrolling.
A beneficiary who sees multiple providers regularly, or who has chronic health conditions, may find Medigap's more predictable cost structure beneficial. After meeting the applicable deductible, covered services are largely addressed by the plan — regardless of frequency of care.
Medigap premiums vary by plan letter, insurer, and individual factors. Medical underwriting may apply outside of Medigap Open Enrollment windows.
Someone newly eligible for Medicare who wants drug coverage and other benefits in a single plan may find Medicare Advantage convenient. Many MA plans bundle Part D and may include additional benefits — though specific benefits vary greatly by plan and location. Always confirm what a specific plan includes before enrolling.
Not all MA plans include all benefit types. Network and formulary restrictions apply. Plan benefits change annually.
A beneficiary who spends significant time in different states may find Medigap convenient because it works with any provider that accepts Medicare anywhere in the country — without network restrictions that apply to many Medicare Advantage HMO plans.
Always confirm provider participation in Medicare before seeking care. Coverage rules may differ in specific situations.
I am a licensed insurance producer. I am not connected with or endorsed by the U.S. Government or the federal Medicare program. Medicare has neither reviewed nor endorsed this information. This is a solicitation for insurance.
Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in a plan depends on the plan's contract renewal with Medicare. Not all plans available in all areas. Plan benefits, premiums, cost-sharing, and networks vary by plan and location and are subject to change annually.
Medicare beneficiaries may also enroll in Medicare Advantage and Part D plans directly through the CMS Medicare Plan Finder at medicare.gov. Always verify current plan information at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).
Let's look at your specific situation together — no pressure, no obligation. A Scope of Appointment will be completed before any Medicare Advantage or Part D plan discussion, as required by CMS.
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