Medicare Supplement Insurance (Medigap) is additional coverage you buy from a private insurance company to help pay Original Medicare out-of-pocket costs like copayments, co-insurance and deductibles, per Medicare.gov. You must have Part A and Part B to buy a Medigap policy. Plans are standardized by letter (A through N in most states) and offer identical benefits across insurers. The Part B deductible is $283 in 2026. High-deductible Plans F and G require $2,950 in costs before coverage begins.
Medicare Advantage vs Medicare Supplement: Key Differences, Pros & Cons
Updated: March 9, 2026
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Key Takeaways
Medicare Advantage replaces Original Medicare with bundled coverage; Medigap supplements it by covering deductibles and copayments.
Most Medicare Advantage plans cost $0 monthly, while Medigap averages $189 per month at age 65.
Medigap lets you see any Medicare-accepting doctor nationwide; Medicare Advantage limits you to network providers.
What Is Medicare Supplement?
What Is Medicare Advantage?
Medicare Advantage is Medicare Part C coverage from private insurance companies approved by Medicare. It bundles Part A (hospital insurance), Part B (medical insurance) and usually Part D prescription drug coverage.
Medicare Advantage offers an average of 32 prescription drug plans per beneficiary in 2026, based on CMS data. Medicare Advantage plans must cover all services Original Medicare covers. Most plans add extra benefits like dental, vision and hearing care.
Medicare Advantage plans cap annual out-of-pocket costs at $9,250 for in-network services. You may need to use doctors in the plan's network and get prior authorization for certain services.
What Are the Differences Between Medicare Advantage and Medicare Supplement?
Medicare Advantage replaces Original Medicare entirely. A bundled plan from a private insurer, it covers Part A, Part B and Part D in most plans and limits you to network providers for non-emergency care. Medicare Supplement (Medigap) works alongside Original Medicare instead, covering out-of-pocket costs, letting you see any Medicare-accepting doctor nationwide and requiring a separate Part D plan for prescriptions. You cannot have both at the same time.
How It Works | Replaces Original Medicare with a bundled plan from a private insurer | Covers out-of-pocket costs left by Original Medicare |
Doctor Choice | Most plans restrict you to the plan's network for non-emergency care | Any doctor or hospital that accepts Medicare, nationwide |
Referrals | Referrals required to see specialists in most plans | No referrals needed to see specialists |
Out-of-Pocket Limits | Plans set a yearly maximum (once you hit it, covered services cost nothing) | Original Medicare has no yearly limit (Medigap adds one) |
Drug Coverage | Prescription drug coverage (Part D) is bundled into most plans | No drug coverage included; buy a separate Part D plan |
Prior Authorization | Certain services and supplies require advance approval | No prior approval needed for Original Medicare-covered services |
Extra Benefits | Plans can include dental, vision, hearing and fitness benefits not covered by Original Medicare | Covers only Medicare-approved services (no added benefits) |
Plan Standardization | Benefits vary by plan and insurer | Every plan with the same letter has identical benefits nationwide |
Foreign Travel | Most plans exclude medical care outside the U.S. | Some plans cover emergency care abroad |
Enrollment Timing | Available during specific enrollment periods (open to anyone first eligible for Medicare) | Best purchased during the six-month Medigap Open Enrollment Period starting when you turn 65 and enroll in Part B |
Cost Structure | Part B premium plus plan premium (some plans are $0), and copayments and coinsurance vary by plan | Part B premium, Medigap premium and Part D premium (Medigap covers most remaining out-of-pocket costs) |
Eligibility Restrictions | Plans C and F unavailable to anyone who turned 65 on or after January 1, 2020 | Requires Original Medicare Part A and Part B (Part B deductible is $283 in 2026) |
Medicare Advantage vs Medicare Supplement Cost Comparison
For 60% of enrollees, Medicare Advantage plans cost $0 monthly, while Medicare Supplement plans average $189 monthly at age 65. Both coverage types require the $202.90 monthly Part B premium. Medical care usage and which Medicare cost-sharing gaps matter most determine your total annual costs.
How Much Does Medicare Advantage Cost?
Most Medicare Advantage plans cost $0 per month in 2026, per MoneyGeek's analysis of plan data. Medicare Advantage enrollees pay the $203 monthly Part B premium and $283 annual deductible. When plans charge premiums, HMO options average $53 monthly and PPO options average $63 monthly. The average out-of-pocket maximum is $6,312 annually, capping total spending on covered services. Until enrollees reach this $6,312 limit, copays and coinsurance come into effect.
HMO | $0 | $53 | 76% | $5,479 |
HMO-POS | $0 | $56 | 66% | $5,725 |
PFFS | $37 | $40 | 10% | $6,387 |
PPO | $0 | $63 | 58% | $6,748 |
Regional PPO | $97 | $88 | 0% | $7,838 |
All Plan Types | $0 | $63 | 60% | $6,312 |
Premium amounts represent consolidated monthly costs for Medicare Part C and Part D coverage based on MoneyGeek's analysis of 2026 Medicare Advantage plan data. Average costs exclude $0 premium plans. Out-of-pocket maximums reflect average in-network limits for 2026. Individual plan costs vary by location, insurer and coverage level. The "% of $0 Premium Plans" column shows the percentage of free plans for each plan type according to the plans we surveyed.
How Much Does Medicare Supplement Cost?
Medicare Supplement plans average $189 monthly at age 65 and $238 monthly by age 75. Plan G covers most Medicare cost-sharing at an average of $220 monthly. High-deductible Plan F starts at $66 monthly but carries a $2,870 deductible before coverage kicks in. Rates vary by hundreds of dollars between insurers offering identical Medigap coverage. Enrollees also pay the $202.90 monthly Part B premium plus a separate Part D plan.
High Deductible Plan F | Full coverage after you meet the $2,870 deductible | $66 | $85 |
$20 & $50 Copay Plan | Covers most Medicare out-of-pocket costs, with $20 copay for office visits, $50 for emergency room visits | $206 | $206 |
Plan A | Covers Part A coinsurance and hospital costs | $213 | $266 |
Plan D | Plan A benefits plus the Part A deductible and foreign travel emergency care | $225 | $306 |
Plan B | Plan A benefits plus the Part A deductible | $257 | $324 |
Plan F | Covers all deductibles and coinsurance | $271 | $342 |
Plan C | Comprehensive coverage including the Part B deductible and foreign travel emergency care | $294 | $381 |
Costs shown represent national average monthly premiums based on MoneyGeek's analysis of Medigap plans. Your actual premium may vary based on your location, insurance company, rating method and health status. Plans C and F are only available to those who became eligible for Medicare before January 1, 2020. You'll also pay the $202.90 monthly Part B premium and a separate Part D premium.
Pros of Medicare Supplement and Medicare Advantage
Medicare Supplement (Medigap) and Medicare Advantage plans each offer distinct benefits for 2026. Medigap policies cover Original Medicare's cost-sharing expenses like the $283 Part B deductible and $434 daily hospital copayments for days 61 to 90. Medicare Advantage plans work differently. Medicare Advantage plans bundle medical and prescription drug coverage while adding dental, vision and hearing benefits. Your choice depends on whether you value provider freedom and predictable costs or prefer bundled coverage with extra perks.
Medigap Pros | Medicare Advantage Pros |
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Cons of Medicare Supplement and Medicare Advantage
Medicare Supplement and Medicare Advantage plans each have coverage gaps and restrictions. Medigap policies sold after 2005 exclude prescription drug coverage, so you must buy separate Part D coverage with deductibles up to $615 in 2026. Medicare Advantage plans limit you to network providers in most cases. Medicare Supplement high-deductible plans require paying $2,950 before coverage starts in 2026.
Cons of Medicare Supplement | Cons of Medicare Advantage |
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How to Choose Between Medicare Advantage and Medicare Supplement
Medicare Advantage and Medicare Supplement Insurance (Medigap) serve distinct purposes for Medicare beneficiaries. Medicare Advantage replaces Original Medicare with an all-in-one private plan that often includes prescription drug coverage and extra benefits. Medigap supplements Original Medicare by covering deductibles, coinsurance and copayments. You can't enroll in both simultaneously.
Doctor and Hospital Access
Medicare Advantage plans restrict you to network providers in most cases. Referrals may be required to see specialists under Medicare Advantage. Medigap paired with Original Medicare lets you see any doctor accepting Medicare nationwide without needing referrals.
Out-of-Pocket Cost Structure
Under Medicare Advantage, copayments apply when you receive care, but yearly spending on covered services has a cap. Fixed monthly premiums define Medigap's cost structure, and Medigap policies cover most Medicare cost-sharing based on which plan letter you select. Your expected medical needs determine whether Medicare Advantage or Medigap costs less overall.
Prescription Drug Coverage
Most Medicare Advantage plans include Part D prescription drug coverage in the base plan. Because Medigap policies don't cover prescriptions, you'll need to join a separate Medicare Part D plan for drug coverage.
Extra Benefits and Travel
Vision, dental, hearing and fitness benefits come with many Medicare Advantage plans. Medigap works with Original Medicare to provide coverage anywhere nationwide, which helps frequent travelers. Medicare Advantage plans limit coverage to their service areas except for emergencies.
Enrollment Timing
Your six-month Medigap Open Enrollment Period starts at age 65 when you enroll in Medicare Part B. Insurance companies can't deny Medigap coverage or charge higher premiums due to health conditions during your Medigap Open Enrollment Period. After your enrollment window closes, higher premiums or coverage denial become possible. Medicare Advantage plans let you switch annually during Open Enrollment from October 15 to December 7.
Medicare Advantage vs Medigap: Bottom Line
Choose Medicare Advantage for $0 monthly premiums and bundled benefits, or select Medigap if you value nationwide doctor access at $189 monthly at age 65. Medicare Advantage replaces Original Medicare with network-based plans, while Medigap supplements Original Medicare and covers deductibles and copayments without provider restrictions.
FAQ: Medicare Supplement vs Medicare Advantage
We've answered common questions about Medicare Advantage vs. Medicare Supplement coverage:
Can I have both Medicare Advantage and a Medicare Supplement plan?
No, you can't enroll in both Medicare Advantage and Medicare Supplement (Medigap) at the same time. Medicare Advantage replaces Original Medicare with a bundled private plan, while Medigap supplements Original Medicare by covering out-of-pocket costs. You must choose one approach to coverage.
Do I need a Medicare Supplement if I have Medicare Advantage?
No, you don't need Medicare Supplement coverage if you have Medicare Advantage. Medicare Advantage replaces Original Medicare and bundles Part A, Part B and usually Part D prescription drug coverage in one plan. Medigap only works with Original Medicare, not with Medicare Advantage plans.
What is the biggest disadvantage of Medicare Advantage?
Network restrictions are the biggest disadvantage. Most Medicare Advantage plans require you to use in-network providers except for emergencies, urgent care or temporary dialysis. This limits your doctor and hospital choices compared to Medicare Supplement plans, which work with any Medicare-accepting provider nationwide.
When can I enroll in Medicare Advantage or Medicare Supplement?
Your six-month Medigap Open Enrollment Period starts at age 65 when you enroll in Medicare Part B. Insurance companies can't deny Medigap coverage or charge higher premiums due to health conditions during this period. Medicare Advantage plans let you switch annually during Open Enrollment from October 15 to December 7.
Can I switch from Medicare Advantage to Medicare Supplement?
Yes, but you have only 12 months to get your old Medigap policy back after switching from Medicare Advantage. After this 12-month window closes, insurance companies can deny coverage or charge higher premiums based on your health conditions. Medical underwriting applies outside your Medigap Open Enrollment Period.
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About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.