Medigap vs Medicare AdvantageComplete Comparison Guide 2025
Understand the key differences between Medigap and Medicare Advantage to make the right choice for your healthcare needs and budget.
Quick Comparison: Medigap vs Medicare Advantage
| Feature | Medigap (Medicare Supplement) | Medicare Advantage |
|---|---|---|
| Works With | Original Medicare (Parts A & B) | Replaces Original Medicare |
| Monthly Premium | $150-$300 + Part B premium | $0-$50 + Part B premium |
| Provider Network | Any doctor that accepts Medicare | Network providers only (HMO/PPO) |
| Out-of-Pocket Costs | Minimal to none (most covered) | Copays/coinsurance per visit |
| Prescription Drug Coverage | Separate Part D plan needed | Usually included |
| Extra Benefits | None (Medicare only) | Dental, vision, hearing, gym |
| Annual Out-of-Pocket Max | No cap (but most costs covered) | $8,850 max (in-network) |
| Travel Coverage | Yes (nationwide & some foreign) | Limited (network area only) |
What is Medigap (Medicare Supplement)?
Medigap (also called Medicare Supplement insurance) is private insurance that works alongside Original Medicare (Parts A and B). It helps pay for out-of-pocket costs that Medicare doesn't cover, such as deductibles, coinsurance, and copayments.
Key Features of Medigap
- Works WITH Original Medicare: You keep Medicare Parts A & B
- Standardized plans: 10 plan letters (A, B, C, D, F, G, K, L, M, N)
- Provider freedom: Any doctor/hospital that accepts Medicare nationwide
- Predictable costs: Monthly premium + minimal out-of-pocket
- Travel coverage: Works anywhere in the US, some plans include foreign travel emergency
Most popular Medigap plans include Plan G (most comprehensive for new enrollees) and Plan N (lower premiums with small copays).
What is Medicare Advantage?
Medicare Advantage (also called Medicare Part C) is an all-in-one alternative to Original Medicare offered by private insurance companies. It replaces Medicare Parts A and B, and typically includes prescription drug coverage (Part D) and extra benefits.
Key Features of Medicare Advantage
- Replaces Original Medicare: One plan for hospital, medical, and usually drugs
- Lower premiums: Many plans have $0 monthly premium (still pay Part B premium)
- Extra benefits: Dental, vision, hearing, gym memberships, OTC allowances
- Network providers: HMO or PPO structure with in-network savings
- Out-of-pocket maximum: Annual cap on your spending ($8,850 in 2025)
Common Medicare Advantage plan types include HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), and Special Needs Plans (SNPs) for specific health conditions.
Cost Comparison: Medigap vs Medicare Advantage
Medigap Costs
Medicare Advantage Costs
Cost Considerations
Healthy individuals with minimal healthcare needs often save money with Medicare Advantage's low premiums. Frequent healthcare users typically save with Medigap's predictable costs and comprehensive coverage. Calculate your expected annual healthcare usage to determine which option saves you money.
Coverage Comparison
| Coverage Area | Medigap | Medicare Advantage |
|---|---|---|
| Hospital Care (Part A) | ||
| Medical Services (Part B) | ||
| Prescription Drugs (Part D) | Separate plan | |
| Deductible Coverage | ||
| Coinsurance Coverage | Copays apply | |
| Dental Coverage | ||
| Vision Coverage | ||
| Hearing Coverage | ||
| Fitness Benefits | ||
| Foreign Travel Emergency |
Provider Networks & Flexibility
Medigap
Medicare Advantage
When to Choose Each Option
Choose Medigap If You:
- Want to see any doctor/specialist who accepts Medicare
- Travel frequently or split time between states
- Have chronic conditions requiring frequent care
- Prefer predictable monthly costs with minimal surprises
- See specialists regularly without referrals
- Want freedom to choose your healthcare providers
- Can afford $150-$300/month premiums
Choose Medicare Advantage If You:
- Want low or $0 monthly premiums
- Need dental, vision, and hearing coverage
- Are generally healthy with minimal healthcare needs
- Prefer all-in-one convenience (medical + drugs + extras)
- Don't mind using network providers
- Live in one area and don't travel extensively
- Value extra benefits like gym memberships and wellness programs
Frequently Asked Questions
What is the main difference between Medigap and Medicare Advantage?
Medigap works with Original Medicare to cover out-of-pocket costs like deductibles and coinsurance. Medicare Advantage replaces Original Medicare entirely with a private insurance plan. Medigap offers more provider flexibility, while Medicare Advantage often has lower premiums but requires using network providers.
Which is cheaper: Medigap or Medicare Advantage?
Medicare Advantage typically has lower monthly premiums (many plans have $0 premiums), but you pay copays and coinsurance for services. Medigap has higher monthly premiums ($150-$300/month) but covers most out-of-pocket costs.
Total annual costs depend on your healthcare usage: Healthy individuals may save with Medicare Advantage, while those with frequent medical needs often save with Medigap's predictable costs.
Can I switch from Medicare Advantage to Medigap?
Yes, you can switch from Medicare Advantage to Medigap, but you may face medical underwriting (health questions) unless you qualify for guaranteed issue rights. The best times to switch are:
- Medicare Advantage Open Enrollment: January 1 - March 31
- Annual Enrollment Period: October 15 - December 7
- Trial Right Period: Within 12 months of joining Medicare Advantage
Which has better coverage: Medigap or Medicare Advantage?
It depends on what "better" means to you:
Medigap: More comprehensive coverage of medical costs, nationwide provider access, no network restrictions. Best for those who value provider freedom and predictable costs.
Medicare Advantage: Includes extra benefits like dental/vision/hearing, prescription drug coverage built-in, lower premiums. Best for those who want all-in-one convenience and extra benefits.
Can I have both Medigap and Medicare Advantage?
No, you cannot have both Medigap and Medicare Advantage at the same time. It's actually illegal for an insurance company to sell you Medigap if you're enrolled in Medicare Advantage. You must choose one or the other. If you have Medigap and want to switch to Medicare Advantage, you must drop your Medigap plan first.
Do Medigap and Medicare Advantage cover prescription drugs?
Medigap: Does NOT include prescription drug coverage. You must enroll in a separate Medicare Part D plan if you want drug coverage.
Medicare Advantage: Most plans (called MA-PD) include built-in prescription drug coverage. Some plans don't include drugs, but you can add a separate Part D plan.
Need Help Choosing Between Medigap and Medicare Advantage?
Our licensed Medicare specialists can help you compare your options, understand the costs, and choose the right coverage for your healthcare needs and budget.
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