Medigap vs Medicare Advantage: Which Is Better?

This is the biggest decision most Medicare beneficiaries face: stay on Original Medicare with a Medigap supplement, or switch to Medicare Advantage. Both approaches have real trade-offs, and neither is universally better. The right choice depends on how you use healthcare, where you live, and what you can afford.

Original Medicare + Medigap

With this combination, you get Parts A and B from the federal government and buy a Medigap policy from a private insurer to cover cost-sharing gaps. You also need a separate Part D plan for prescriptions. Total monthly cost: Part B premium ($202.90 in 2026) plus Medigap premium (varies, typically $100 to $300+) plus Part D premium. The advantage: you can see any doctor or hospital in the country that accepts Medicare. No networks, no referrals, no prior authorization. With Plan G (the most popular Medigap plan), your only out-of-pocket cost after premiums is the $283 Part B deductible per year.

Medicare Advantage

With Medicare Advantage, one plan replaces Parts A and B and usually includes Part D. Monthly cost: Part B premium ($202.90) plus the MA plan premium (often $0, average $14). Lower total premiums, but you use a provider network and face copays, coinsurance, and a spending cap ($9,250 max in-network for 2026). Most plans add dental, vision, hearing, and other extras that Original Medicare and Medigap don't cover.

Choose Medigap If

You want to see any Medicare-accepting doctor nationwide. You travel often or live in multiple places. You have complex medical needs and see specialists across different systems. You want predictable costs with minimal out-of-pocket surprises. You can afford the higher monthly premiums.

Choose Medicare Advantage If

You want lower monthly premiums. You're comfortable using a provider network. You want dental, vision, and hearing included. You don't travel much and get care locally. You want drug coverage bundled in one plan.

The Lock-In Warning

If you start with Medicare Advantage, switching to Original Medicare + Medigap later can be difficult. After your initial Medigap Open Enrollment Period (6 months from turning 65 and enrolling in Part B), insurers in most states can use medical underwriting for Medigap. They can deny you or charge more based on health conditions. This is one reason some advisors suggest starting with Medigap if you can afford it.