Medicare Advantage vs Medicare Supplement: Key Differences, Pros & Cons

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Updated: August 13, 2026

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Key Takeaways
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Medicare Advantage replaces your Original Medicare coverage entirely. Medicare Supplement, also called Medigap, works alongside Original Medicare to cover the out-of-pocket costs it leaves behind. You can't use both at the same time.

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For 60% of enrollees, Medicare Advantage plans cost $0 per month. Medigap averages $189 per month at age 65. Lower monthly premiums don't always mean lower total spending. How much medical care you actually use determines which plan costs you less overall.

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Medigap lets you see any doctor or hospital that accepts Medicare, anywhere in the country, with no referrals needed. Medicare Advantage limits you to a provider network for non-emergency care. If your current doctors or specialists aren't in a local plan's network, you may need to switch providers or pay out-of-network rates.

What Are the Differences Between Medicare Advantage and Medicare Supplement?

My analysis of how these two Medicare options work shows one clear structural difference: Medicare Advantage replaces your Original Medicare coverage entirely. Medigap supplements it. That difference determines your doctors, your costs and how much flexibility you have in ways that matter more than any single premium figure.

Original Medicare, the federal government's Part A (hospital coverage) and Part B (doctor visits and outpatient services) program, doesn't pay all your medical costs. You still owe copayments, coinsurance and deductibles when you use care. Both Medicare Advantage and Medigap address those gaps, but in entirely different ways. You can't 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)

Buy during the six-month Medigap Open Enrollment Period that starts 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

Must be enrolled in Medicare Parts A and B and live within the plan's service area

Must be enrolled in Medicare Parts A and B; Plans C and F unavailable to enrollees who first became eligible for Medicare on or after January 1, 2020

The six-month Medigap Open Enrollment Period is the only window where insurers can't deny you coverage or charge more based on your health history. If you miss this deadline, your Medigap options change permanently and most people realize that too late.

What Is Medicare Supplement?

Medicare Supplement Insurance, also called Medigap, is a private insurance policy that covers what Original Medicare doesn't pay. Those costs include copayments (fixed amounts per visit), co-insurance (your share of a bill) and deductibles (amounts you owe before coverage begins). Plans are standardized by letter, A through N in most states.

Every insurer selling Plan G must provide identical benefits, so you're comparing price and company reliability, when you shop. The Part B deductible is $283 in 2026. High-deductible Plans F and G lower monthly premiums by requiring you to cover $2,950 in costs before coverage begins. That shifts more risk to you upfront.

You're eligible for a Medigap plan if:

  • You're 65 or older and enrolled in Medicare Part A and Part B
  • You live in the state where the plan is sold
  • In some states, you may qualify if you're under 65 with a qualifying disability or end-stage renal disease (ESRD, means permanent kidney failure that requires dialysis or a transplant)
  • Massachusetts, Minnesota and Wisconsin don't use the A-through-N lettered plan structure available in other states. Each has its own standardized plan options with different names and benefit structures. If you live in one of these states, contact your state's insurance department for local plan options.

What Is Medicare Advantage?

Medicare Advantage, also called Part C, is sold by private insurance companies the federal government approves to deliver Medicare benefits. It bundles Part A (hospital coverage), Part B (doctor visits and outpatient care) and, in most plans, Part D (prescription drugs) into one policy. Most plans add routine dental, vision and hearing care. 

Most plans require you to use doctors and hospitals within the plan's provider network for non-emergency care. For certain services, plans require prior authorization. The plan must approve care before you receive it. Approval can be delayed or denied, a common barrier to timely medical care for Medicare Advantage enrollees.

To enroll in Medicare Advantage, you must meet all of the following:

  • You're enrolled in Medicare Part A and Part B
  • You live within the plan's service area
  • You're a U.S. citizen or lawfully present in the United States
  • Some plans allow enrollment for people under 65 who are eligible for Medicare because of a disability

Advantages of Medicare Supplement and Medicare Advantage

Medigap covers the cost gaps Original Medicare leaves behind. This includes $283 Part B deductible and $434 daily hospital copayments for days 61 to 90. Medicare Advantage bundles medical, prescription drug, dental, vision and hearing benefits into one policy. The right plan depends on which structure fits how you use care.

Medigap's advantage is predictability. You pay the monthly premium and owe no unexpected costs when you use care. Medicare Advantage costs less upfront for people who use minimal care year to year.

Medigap Pros
Medicare Advantage Pros
  • Works with any doctor or hospital that accepts Original Medicare nationwide
  • No provider networks or referrals required for specialist care
  • Predictable out-of-pocket costs with comprehensive coverage of Medicare copays and deductibles
  • Plan benefits stay the same year after year
  • Coverage travels with you anywhere in the U.S.
  • High-deductible Plan G carries a $2,950 deductible in 2026 in exchange for lower monthly premiums than standard Plan G
  • Often includes prescription drug coverage (Part D) built into the plan
  • Adds extra benefits like dental, vision, hearing aids and fitness programs
  • Lower or zero-dollar monthly premiums in many areas
  • Caps annual out-of-pocket spending at $2,100 for prescription drugs in 2026
  • Combines medical and prescription coverage in one plan
  • Insulin copays capped at $35 or 25% of negotiated price in 2026, whichever is less

Disadvantages of Medicare Supplement and Medicare Advantage

Medigap plans sold after 2005 don't include prescription drug coverage. You must buy a separate Part D plan, which carries its own deductible, up to $615 in 2026. Medicare Advantage limits you to network providers for non-emergency care. High-deductible Medigap plans require $2,950 in out-of-pocket costs before coverage begins.

We found that Medigap's biggest drawbacks are premium costs and the absence of prescription drug coverage. Medicare Advantage's biggest drawbacks are network restrictions and the difficulty of returning to Medigap once you leave.

Cons of Medicare Supplement
Cons of Medicare Advantage
  • Medicare Supplement plans sold after 2005 don't include prescription drug coverage. Buy a separate Medicare Part D plan for prescriptions
  • Medigap policies don't cover vision, dental, hearing aids, long-term care or private-duty nursing
  • Medical underwriting can deny Medigap coverage or increase costs if you buy outside your six-month open enrollment period
  • Each spouse needs a separate Medigap policy (one policy covers only one person)
  • Many Medicare Advantage plans require you to use in-network providers except for emergencies, urgent care or temporary dialysis
  • Medicare Advantage plans can leave Medicare or change service areas annually, and you'll need to find new coverage
  • Medicare Advantage enrollment may cause you to lose employer or union coverage for yourself and dependents
  • Trial period to return to Medigap lasts 12 months only

If you switch from Medigap to Medicare Advantage, you have 12 months to return to your Medigap policy without health screening. After that window closes, insurers can review your medical history before approving coverage. Health changes during this time result in higher premiums or a total denial of coverage. Most people don't know about this risk before they switch.

Medicare Advantage vs. Medicare Supplement Cost Comparison

For 60% of enrollees, Medicare Advantage plans cost $0 per month. Medigap averages $189 per month at age 65. Both types require the $202.90 monthly Part B premium. Your total healthcare spending depends on how much medical care you use and which Medicare cost gaps affect you most.

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 $202.90 monthly Part B premium. When plans charge premiums, HMO options average $53 monthly and PPO options average $63 monthly.

The average in-network out-of-pocket maximum is $6,312 annually. Once enrollees reach that ceiling, covered services cost nothing for the rest of the year. Until then, copays and co-insurance apply.

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.   

An HMO plan averages $5,479 in maximum annual out-of-pocket costs, compared to $7,838 for a regional PPO. We found that difference, is what drives a $2,359 annual difference in what Medicare Advantage enrollees actually pay in years when they need a lot of care. The HMO structure gives you a lower ceiling on annual spending.

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 $2,950 deductible before coverage begins. 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.

Medigap Plan A

Covers Part A coinsurance and hospital costs
$213
$266

Medigap Plan B

Covers Plan A benefits plus the Part A deductible
$257
$324

Medigap Plan C

Covers Plan B benefits plus the Part B deductible and foreign travel emergency care
$294
$381

Medigap Plan D

Covers Plan A benefits plus the Part A deductible and foreign travel emergency care
$225
$306

Medigap Plan F

Covers all Medicare-approved deductibles and coinsurance; most comprehensive plan available
$271
$342
Medigap Plan F High Deductible
Same coverage as Plan F but requires you to pay $2,950 in costs before coverage begins; carries lower monthly premiums
$66
$85

Medigap Plan G

Covers nearly all Medicare costs except the Part B deductible; most popular plan for new enrollees since 2020
$220
$279
Medigap Plan G High Deductible
Same coverage as Plan G but requires you to pay $2,950 before coverage begins; carries lower monthly premiums
$61
$79

Medigap Plan K

Covers 50% of most Medicare cost-sharing; has an annual out-of-pocket limit after which the plan pays 100%
$110
$139

Medigap Plan L

Covers 75% of most Medicare cost-sharing; has an annual out-of-pocket limit after which the plan pays 100%
$179
$226

Medigap Plan M

Covers Plan A benefits plus 50% of the Part A deductible and foreign travel emergency care
$185
$239

Medigap Plan N

Covers most Medicare costs but requires a copay of up to $20 for office visits and up to $50 for emergency room visits
$171
$221

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 people 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 for drug coverage.

Medigap premiums for the same plan letter can vary by more than $150 per month at age 65 depending on the insurer and your location. Every carrier's Plan G covers identical benefits. That price spread reflects how differently companies price and manage the same risk pool.

Compare multiple carriers for the same plan letter. Every Plan G covers identical benefits by law, so the only variables are price and the insurer's financial strength rating.

How to Choose Between Medicare Advantage and Medicare Supplement

Your choice depends on how you use care, which doctors you want to keep and how predictable your costs need to be. If you rarely need specialist care and want to keep monthly premiums low, Medicare Advantage is the stronger fit. Medigap is likely the better choice, if you have specialist relationships you want to keep, travel frequently between states or expect to use a lot of care.

Choose Medicare Supplement if...
Choose Medicare Advantage if...

Your current doctors, specialists or hospitals might not be in a local Medicare Advantage network and switching providers isn't something you're willing to do. Medicare Advantage networks change annually, so a doctor in-network today may not be in-network next year.

You're in good health and don't expect to use a lot of medical care. Medicare Advantage's $0 monthly premium costs less than Medigap when you're not using many services.

You travel frequently between states or split time between locations. Medigap works with any doctor who accepts Medicare nationwide. Medicare Advantage limits your coverage to the plan's service area for non-emergency care.

You want prescription drug coverage, dental, vision and hearing care in one plan without buying and managing separate policies for each benefit.

You have complex or chronic conditions requiring frequent specialist visits. Medigap doesn't require referrals and doesn't have prior authorization requirements for Original Medicare-covered services.

Your preferred doctors and hospitals are confirmed in-network. Verify this directly with the plan before enrolling. Provider directories can be outdated.

You want predictable costs. The monthly Medigap premium is fixed, and you'll owe little or nothing when you use care, regardless of how much care you need that year.

You live in one area year-round and don't seek care across multiple states. Medicare Advantage is the stronger fit when your local network covers your doctors and you don't seek care across multiple states.

You became eligible for Medicare before January 1, 2020, which makes you eligible for Plan F, the most comprehensive Medigap option. Enrollees who turned 65 on or after that date can't access Plan F.

You want a hard annual ceiling on total medical spending. Medicare Advantage plans cap in-network costs at $9,250 in 2026. That gives you a firm ceiling on annual spending.

How to Switch Medicare Plans?

The decisive factor for switching between Medicare Advantage and Medigap is whether you qualify for guaranteed-issue rights. With these rights, an insurer must sell you a Medigap policy at standard rates without reviewing your health history first.

Without guaranteed-issue rights, a Medigap insurer can review your medical history and either charge you more or decline your application. That's an important distinction from Medicare Advantage, which must accept any enrollee who meets basic enrollment requirements regardless of health status.

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    Switching From Medigap to Medicare Advantage

    To switch from Medigap to Medicare Advantage, wait for Medicare Open Enrollment, which is from October 15 to December 7 each year. You can enroll in a Medicare Advantage plan during that window. Your Medigap coverage ends and your new Medicare Advantage plan takes effect January 1 of the following year.

    Before you switch, confirm that your current doctors and preferred hospitals are in the Medicare Advantage plan's network. Once you drop your Medigap policy to join Medicare Advantage, a return to Medigap at standard rates requires qualifying for guaranteed-issue rights. This option is not guaranteed and depends entirely on your health history at that time.

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    Switching From Medicare Advantage to Medigap

    To switch from Medicare Advantage to Medigap requires two steps. First, disenroll from Medicare Advantage and return to Original Medicare. Then apply for a Medigap policy. You can disenroll during the Medicare Advantage Open Enrollment Period, which is from January 1 to March 31 each year.

    Once you return to Original Medicare, you apply for Medigap. Without guaranteed-issue rights, insurers can screen your health history before approving your application. You have a 12-month trial right if it's your first time in Medicare Advantage and you enrolled when you first became eligible. That window doesn't repeat.

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About Mark Fitzpatrick

Mark Fitzpatrick, Licensed P&C Insurance Expert, MoneyGeek

Mark Fitzpatrick is a licensed Property and Casualty (P&C) Insurance Producer in Connecticut and MoneyGeek's resident expert in insurance and economics. In nearly a decade covering the insurance market at LendingTree and MoneyGeek, he's analyzed hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

His work has appeared in The Washington Post, The New York Times and NPR. He draws on independent cost and consumer experience data, and no insurance company partnerships affect his recommendations.

Mark studied at Boston College and later earned a master's in economics and international relations from Johns Hopkins University. He worked in financial risk management at State Street before joining MoneyGeek. He's also a five-time “Jeopardy!” champion.

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