Medicare offers a variety of coverage options. While many people are familiar with original Medicare, also known as parts A and B, some may be less familiar with Medicare Advantage, also known as Part C, or Medigap, also called Medicare Supplement Insurance.
Both Medicare Advantage and Medigap can help cover health care costs. It’s important to understand the variety of options to find coverage that best meets your health care needs.
[Read: 5 Steps for Picking a Medicare Plan.]
Original Medicare and Medicare Advantage: What’s the Difference?
Let’s start with the basics. There are two different ways to get your Medicare coverage: original Medicare and Medicare Advantage.
Original Medicare
Original Medicare, sometimes called traditional Medicare, consists of two parts (A and B) with the option to add additional insurance, such as a Medigap plan or Medicare’s drug benefit program (Part D).
The two core parts are:
— Medicare Part A (hospital insurance). Part A covers inpatient care, such as hospital stays, short-term skilled nursing facility care, hospice care and some home health care services.
— Medicare Part B (medical insurance). Part B covers outpatient care, such as visits to the doctor, preventive services, durable medical equipment like wheelchairs or walkers and some home health care services.
Together, they provide comprehensive coverage for a wide range of essential medical services. There are gaps, however, such as a lack of prescription drug coverage. You will need to sign up for Medicare Part D to have your prescriptions covered.
[READ Understanding Parts of Medicare: A Through N Explained]
Medicare Advantage
Medicare Advantage plans, also known as Part C, resemble employer-based insurance and are offered by private insurers. They must cover all services included in Medicare parts A and B, and many also include “extra” benefits, such as prescription drug coverage, routine dental services and vision, that original Medicare does not cover.
Unlike original Medicare, which allows you to go to any doctor anywhere who participates in Medicare, Medicare Advantage plans typically limit care to those medical providers who are in-network and within a certain geographical area.
“In most situations, if the beneficiary travels outside of the plan’s service area, they will only have coverage for emergency services,” says Kelli Jo Greiner, a health care policy analyst with the Minnesota Board on Aging in St. Paul, Minnesota.
Medicare Advantage plans can be purchased during Medicare’s open enrollment period from October 15 through December 7 or when you first enroll in Medicare. Even if you apply for Medicare Advantage, you will still need to enroll in Medicare parts A and B, including paying the premiums. Some Medicare Advantage plans, however, offer what’s known as a “Plan B giveback,” to help offset that premium cost.
[READ: Medicare Hearing Aid Coverage for 2026]
How Do Medigap Plans Work?
Original Medicare has out-of-pocket expenses, such as copays and deductibles, and it does not have an out-of-pocket yearly maximum. Beneficiaries usually pay 20% once the deductible is met for Part B-covered services. To help cover out-of-pocket costs, which can quickly add up, beneficiaries may purchase a Medigap plan.
Medigap plans, which are labeled Plan A through N, are sold by private insurers but are regulated by both federal and state laws to provide standardized protections for beneficiaries. For example, all Medigap Plan As must offer the same benefits, but they are administered by different companies and may have different premiums. You can see the benefits of each lettered plan on Medicare’s comparison page or U.S. News’ Medigap search and compare tool.
One thing to note is, as of January 2020, Medigap Plan F is generally no longer available to new Medicare enrollees. However, if you turned 65 before January 1, 2020, you may still be able to purchase Plan F if it’s offered in your state. Medigap Plan G offers similar coverage to Plan F, with one key difference: It does not cover the Medicare Part B deductible.
Medigap plans also do not help cover some expenses, such as out-of-pocket expenses for prescription drugs, which are administered under Medicare Part D. The out-of-pocket maximum for medications in 2026 is $2,100.
When Can You Get a Medigap Plan?
To buy a Medigap policy, you must be enrolled in original Medicare. The best time to enroll is during your six-month Medigap open enrollment period. This window — not to be confused with the Medicare open enrollment period — begins when you’re 65 or older and first enrolled in Part B. During this one-time enrollment period, insurers can’t deny you coverage or charge more because of your health conditions.
“Outside of certain periods during which Medigap issuers must sell people plans, such companies can decline people policies or charge more, based on preexisting conditions,” says David Lipschutz, the co-director and attorney for the Center for Medicare Advocacy in Washington, D.C.
Currently, only four states — Connecticut, Maine, Massachusetts and New York — provide the right to purchase a Medigap plan annually, according to KFF.
Medigap vs. Medicare Advantage: Key Differences
There are some key differences to keep in mind when you are choosing what works best for you.
| Original Medicare | Medicare Advantage | Original Medicare with Medigap | |
| Copays, coinsurance | 20% deductible for Part B | Plan dependent | Can pay up to 100% after the deductible, depending on the plan and service |
| Network | See any doctor who participates in Medicare | Limited to in-network doctors | See any doctor who participates in Medicare |
| Deductible | Part B is $283 in 2026 | Yes, but varies | Part B is $283 in 2026 |
| Drug coverage | You must enroll in Part D | Plan dependent | You must enroll in Part D |
| “Extra benefits” | No | Routine vision, dental, hearing and other benefits | No |
| Out-of-pocket limits | No | Can be as high as $9,250 in 2026 for in-network, depending on the plan | Covers many out-of-pocket expenses for both Part A and Part B |
| Premiums | Part A and Part B | Part B and possible additional premium | Original Medicare premiums plus a Medigap premium |
| Referrals needed | No | Needed for most plans | No |
Can You Have Both Medigap and Medicare Advantage?
No, a Medigap policy cannot be used with a Medicare Advantage plan.
If you decide at some point to switch to Medicare Advantage, be sure to cancel your Medigap policy so you are not stuck paying the premium for something you cannot use. If you join a Medicare Advantage plan and are not satisfied, once you switch back to original Medicare, you have a one-year period to return to your Medigap plan as long as it is offered by the same insurance company (a one-time trial right provision).
What Are the Cost Differences?
The biggest difference is that while both original Medicare and Medicare Advantage plans have out-of-pocket costs, Medigap plans cover out-of-pocket costs associated with original Medicare, while Medicare Advantage plans do not have this benefit. Medigap allows beneficiaries to have minimal out-of-pocket spending.
“If you have questions, every state has a federally designated State Health Insurance Assistance Program (SHIP), which provides objective, unbiased Medicare counseling and can assist with plan selection and enrollment,” Greiner says.
Medigap
For Medigap plans, you must pay any Part A and Part B premiums, plus the premium charged by the insurer you purchase your Medigap plan from. For many, Part A is $0 because of the number of working years paid into the Medicare system (generally 10 or more), and Part B is $202.90 in 2026.
You will still need to pay any out-of-pocket expenses that your plan has, though the point of adding a Medigap plan to original Medicare is to help reduce your out-of-pocket costs. Specialists at your local SHIP office can help guide you through what you qualify for and the costs associated with it.
Medicare Advantage
For Medicare Advantage plans, you still need to pay your Part B premiums as well as any premium necessary for the Medicare Advantage plan you select. You will also need to pay any out-of-pocket expenses that your plan has.
Be mindful of double-checking what changes, if any, your plan will have in the coming year.
“Medicare Advantage plans may change their benefits and networks every year, so if a plan suits you this year, it is no guarantee that the same plan will suit you next year,” says Lipschutz, adding, “Annual research into plan benefits is really recommended.”
Choosing the Right Plan for You
There are many factors that go into choosing a health care plan, including the associated costs and benefits of each plan and how healthy you are. Without a crystal ball, it can be hard to determine exactly what your needs will be in the coming years, but talking to your doctor may be one way to help narrow down what benefits you should include.
Don’t forget to factor in prescription medication costs and if you think you will need routine dental or vision care in the upcoming year. If you want the reassurance that you are covered from any major medical bills as well as day-to-day out-of-pocket expenses, then a Medigap policy is the way to go.
Bottom Line
Both Medicare Advantage and Medigap plans have some important benefits and limitations that should not be overlooked when weighing decisions for health care coverage.
The additional benefits bundled in Medicare Advantage plans might be precisely what you need. On the other hand, Medigap plans offer peace of mind by covering out-of-pocket expenses, especially in situations involving costly medical services, like hospital stays. While Medigap plans may come with higher premiums than Medicare Advantage plans, they can be a big money-saver overall, depending on your health care usage.
Talk to your doctor, a licensed health insurance advisor or an independent Medicare agent to find out which plan is right for you.
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Medigap vs. Medicare Advantage: Which Should You Buy? originally appeared on usnews.com
Update 01/09/26: This story was published at an earlier date and has been updated with new information.
