Medigap or Medicare Advantage?

Medicare Advantage usually costs less in a healthy year. Original Medicare with a Medigap plan usually costs less, and keeps more doctors open to you, in a bad one. Put in the plans you’re considering to see both.

Then check your drugs on each with the drug checker, and your doctors with doctor search.

Original Medicare + Medigap + drug plan

Medigap plan

Medigap premium per month

Quotes vary by age, state, and insurer.

Drug plan premium per month

Medicare Advantage plan

Plan premium per month

Many plans are $0; you still pay the Part B premium.

In-network out-of-pocket maximum

In the plan’s Summary of Benefits. No plan’s can be over $9,250 in 2026.

Primary care copay

Specialist copay

What a year would cost you

Premiums plus your share of medical costs. Both paths also pay the Part B premium, and drug costs are capped the same way on both, so those are left out.

	Original + Medigap G	Medicare Advantage
A light year A few doctor visits and routine labs	$2,563	$80
A bad year Surgery, a hospital stay, or cancer treatment	$2,563	$5,500

Original + Medigap G

Medicare Advantage

A light year

A few doctor visits and routine labs

$2,563

$80

A bad year

Surgery, a hospital stay, or cancer treatment

$2,563

$5,500

A bad year means reaching your plan’s in-network out-of-pocket maximum (no plan’s can be over $9,250 in 2026). Out-of-network care in a PPO has a higher limit; in an HMO it usually isn’t covered.

Beyond cost

Doctors and hospitals
Original + Medigap
Any doctor or hospital in the U.S. that accepts Medicare.
Medicare Advantage
Usually a local network. HMOs cover out-of-network care only in emergencies.
Approvals
Original + Medigap
Prior authorization is rare.
Medicare Advantage
Prior authorization is common for scans, surgery, hospital stays, and rehab.
Referrals
Original + Medigap
Not needed.
Medicare Advantage
HMOs often need them to see a specialist.
Dental, vision, hearing
Original + Medigap
Not covered; you can buy separate plans.
Medicare Advantage
Often includes some coverage or allowances.
Travel
Original + Medigap
Covered anywhere in the U.S.; some Medigap plans cover emergencies abroad.
Medicare Advantage
Mostly limited to the plan’s area except emergencies.
Switching later
Original + Medigap
You can move to Medicare Advantage in any open enrollment.
Medicare Advantage
Moving back to Original Medicare is easy, but in most states Medigap insurers can then turn you down or charge more for health conditions. Exception: a 12-month “trial right” if you joined Medicare Advantage when you first got Medicare at 65, or dropped a Medigap policy to try Medicare Advantage for the first time; within that year you can switch back and buy Medigap without health questions.

	Original + Medigap	Medicare Advantage
Doctors and hospitals	Any doctor or hospital in the U.S. that accepts Medicare.	Usually a local network. HMOs cover out-of-network care only in emergencies.
Approvals	Prior authorization is rare.	Prior authorization is common for scans, surgery, hospital stays, and rehab.
Referrals	Not needed.	HMOs often need them to see a specialist.
Dental, vision, hearing	Not covered; you can buy separate plans.	Often includes some coverage or allowances.
Travel	Covered anywhere in the U.S.; some Medigap plans cover emergencies abroad.	Mostly limited to the plan’s area except emergencies.
Switching later	You can move to Medicare Advantage in any open enrollment.	Moving back to Original Medicare is easy, but in most states Medigap insurers can then turn you down or charge more for health conditions. Exception: a 12-month “trial right” if you joined Medicare Advantage when you first got Medicare at 65, or dropped a Medigap policy to try Medicare Advantage for the first time; within that year you can switch back and buy Medigap without health questions.

Did this help you figure out your next step?