Side by side
Swipe the table sideways to see all columns.
| Original Medicare + Medigap | Medicare Advantage | |
|---|---|---|
| Doctors and hospitals | Any provider in the U.S. that accepts Medicare | Usually a network. Out of network may cost more or not be covered |
| Monthly cost | Part B premium + Medigap premium + drug plan premium | Part B premium + the plan's premium, often low or $0 |
| When you get care | Little or nothing, depending on the Medigap plan | Copays and coinsurance, up to the plan's yearly out-of-pocket limit |
| Yearly limit on costs | Original Medicare has none; Medigap fills most of the gaps | Yes, every plan has one |
| Drug coverage | Separate Part D plan | Usually included |
| Referrals and prior approval | Rarely | Often needed |
| Extras (dental, vision, hearing) | Not included | Often some |
| Travel in the U.S. | Works everywhere Medicare is accepted | Mostly local, except emergencies |
Why timing matters most
You get one 6-month Medigap Open Enrollment, starting the first month you're 65 or older and have Part B. During it, an insurer must sell you any Medigap policy it offers in your state at its standard price, whatever your health. After it ends, in most states insurers can charge more or say no. So choosing Medicare Advantage first and switching to Medigap later isn't always possible.
There is a safety net called a trial right: if you join a Medicare Advantage plan when you first get Medicare at 65, you can switch to Original Medicare within the first 12 months and buy a Medigap policy without health questions.
Who each one tends to suit
- Medigap often suits people who want any doctor, travel a lot, have health problems that mean frequent care, or want predictable costs and can afford the higher premium.
- Medicare Advantage often suits people who are fine with a network, want a low monthly premium, and like having drugs and extras in one plan.
Compare actual plans in your ZIP code with the Medicare Plan Finder at Medicare.gov. Free one-on-one help is available from your State Health Insurance Assistance Program (SHIP).
Medigap plans
Medigap plans are standardized and named by letters: A, B, C, D, F, G, K, L, M and N. The same letter covers the same things from every insurer; only the price differs. Plans C and F aren't available to people who became eligible for Medicare on or after January 1, 2020. Massachusetts, Minnesota and Wisconsin have their own standardized plans.
Questions
What is the difference between Medigap and Medicare Advantage?
Medigap is extra insurance that works with Original Medicare and pays some of the costs Medicare leaves to you. Medicare Advantage replaces Original Medicare with a private plan that usually has a network of doctors and often includes drug coverage. You can't have both at the same time.
Can I switch from Medicare Advantage to Medigap later?
You can go back to Original Medicare during Open Enrollment, but in most states a Medigap insurer can then charge more or turn you down because of your health. Exceptions include a trial right: if you joined Medicare Advantage when you first got Medicare at 65, you can switch back within 12 months and buy Medigap without health questions.
Does Medigap cover prescription drugs?
No. Medigap policies sold today don't include drug coverage, so most people with Medigap also join a separate Part D drug plan.
Updated November 6, 2026. Sources: Medicare.gov, Choosing a Medigap Policy (official guide); Medicare.gov, When can I buy a Medigap policy?; Medicare.gov, Understanding Medicare Advantage & Medicare Drug Plan Enrollment Periods. General information, not insurance advice. We don't sell insurance.