One of the most common questions we hear is some version of: “What’s the difference between Medicare Advantage and a Medigap plan, and which one should I get?” There’s no universal right answer — it depends on your health, your budget, and how you like to access care. Here’s a general breakdown to help you think it through.
How Original Medicare Works on Its Own
Original Medicare (Part A and Part B) covers hospital and outpatient medical care, but it doesn’t cover everything. In 2026, the Part B deductible is $283, and after that Medicare generally pays 80% of approved outpatient costs — leaving you responsible for the other 20%, with no cap on how high that could go in a bad year. That gap is exactly why most people pair Original Medicare with either a Medigap policy or a Medicare Advantage plan.
Medicare Advantage: All-in-One Coverage
Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare. They typically bundle hospital, medical, and often prescription drug coverage into one plan, frequently with extra benefits like dental, vision, or hearing. Many Advantage plans have low or $0 premiums, but they usually work through networks — meaning you may need to use in-network doctors and get referrals for specialists, similar to an HMO or PPO. Out-of-pocket costs (copays, coinsurance) apply as you use care, up to an annual maximum.
Medigap: Filling the Gaps in Original Medicare
A Medigap (Medicare Supplement) policy works alongside Original Medicare to help cover some of the costs Medicare doesn’t — like coinsurance, copays, and in some plans, the Part B deductible. Medigap plans typically let you see any provider nationwide that accepts Medicare, with no network restrictions or referrals needed. The tradeoff is usually a higher monthly premium than many Advantage plans, plus you’d typically pair it with a standalone Part D prescription drug plan.
Key Questions to Ask Yourself
- Do I travel often or split time between states? Medigap’s lack of network restrictions can matter here.
- Am I comfortable with a plan network, or do I want to see any provider without a referral?
- How do I want to budget — a higher fixed monthly premium (Medigap) or lower premium with cost-sharing as I use care (Advantage)?
- What extra benefits matter to me? Many Advantage plans include dental, vision, and hearing coverage that Original Medicare and Medigap don’t.
There’s No One “Best” Plan
We’re often asked to just name the best plan, but honestly, the right choice depends entirely on your health needs, providers, medications, and budget — which is why we don’t make blanket recommendations. What we can do is walk through your specific situation, compare how the two paths would actually play out for you, and help you understand the tradeoffs clearly. You can browse a general overview of both paths on our coverage options page, or if annuities and other retirement income tools are also on your radar, our annuities page covers how those fit into a broader retirement plan.
If you’d like to talk through your specific situation, schedule a free consultation and we’ll go over your options together — no pressure, no obligation.
Informational purposes only. This article is for general education and reflects 2026 Medicare figures; it is not insurance, legal, or financial advice, and does not recommend any specific plan. Kayla Price is a licensed insurance agent (NPN 18530055) with Price Services Group, an independent agency not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE (1-800-633-4227) for a complete view of all your options.