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Original Medicare has health care coverage gaps, making it necessary for some individuals to choose another insurance option. Both Medicare Advantage and Medigap are alternatives to traditional Medicare. They are not government-run programs but are available through private insurers. Those with certain disabilities or who are 65 or older are eligible for either plan. Although you can switch between the two plans, you can’t have both Medigap and Medicare Advantage simultaneously.

Key Takeaways

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Medigap offers supplemental plans for Original Medicare to fill traditional Medicare gaps. Monthly costs are generally higher than Medicare Advantage plans, but more services are covered, leaving fewer out-of-pocket costs.

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Medicare Advantage (Part C) offers an all-in-one policy for Parts A, B and D. While it is convenient and usually has cheaper premiums than Medigap, Medicare Advantage does not cover as many services.

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Medigap can benefit those who require more intensive health care coverage, while Medicare Advantage would be a better option for those only needing basic care.

Difference Between Medigap and Medicare Advantage

Although both offer health care coverage to fill the gaps left by Original Medicare, there are many differences between Medigap and Medicare Advantage plans. The differences between the Medicare supplement and Medicare Advantage policies are outlined in the table below.

Comparing Characteristics of Medigap and Medicare Advantage
Medigap (Medicare Supplement)
Medicare Advantage (Part C)


Original Medicare plus
supplemental Medigap plans

Combines Part A, B
and, sometimes, D
under one policy

Network Restrictions



Need Physician




Usually Higher

Usually Lower





  • Usually higher premiums but
    lower out-of-pocket costs
  • No copays
  • Separate Part B premiums
  • Low or no-cost premiums
    but copays and higher
    deductibles and co-insurance
  • Part B premium is separate


Any time (once eligible)

  • Three months before/after
    65th birthday (seven months
  • Open enrollment
  • Special enrollment

Nationwide Coverage


(Emergency Services Only)



Sometimes, but not often

Prescription Drug

Not usually


Original Medicare Coverage and Costs

Original Medicare is available for those 65 and older or who have certain qualifying conditions. It covers Parts A and B. Part A is hospital insurance, and Part B is medical insurance. Your premium depends on your time paying into Medicare taxes and your income.

Part A covers inpatient treatment like skilled nursing, hospitals, hospice and certain home health care services. There are no premiums for people who paid at least 40 quarters of Medicare taxes. Monthly premiums are $278 for those with 30 to 39 quarters of payments or $506 for those with fewer than 30 quarters. There may be a deductible to meet and 20% co-insurance to pay per service.

Part B covers doctor visits and outpatient procedures, with a starting premium of $164.90 per month. The premium is higher for those with incomes of $91,000 or more. Once the $226 deductible is met, the patient usually has a 20% co-insurance responsibility.

Premiums and deductibles are adjusted each calendar year. If you choose to add a supplement plan, your premium will increase.

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Gaps in Original Medicare Coverage

There are gaps in Original Medicare coverage that can create a need for other options like Medicare Advantage or Medigap plans. The gaps include co-insurance considerations, medical costs that aren’t covered and the potentially high out-of-pocket costs for long hospital stays.

  • 80/20 co-insurance split: There is no out-of-pocket maximum, so paying 20% of the co-insurance costs can become expensive, especially for large inpatient bills.
  • Routine services not covered: Original Medicare doesn’t cover dental, hearing and vision, and there is usually no coverage for international travel. It also doesn’t cover prescriptions unless you pay for Medicare Part D prescription coverage, which is included in Medicare Advantage but not Medigap plans.
  • Long hospital stays: It can be costly to stay in the hospital long-term on Original Medicare. The initial $1,600 deductible covers the first 60 days. Beyond that, there is $400 daily co-insurance for days 61–90 and $800 daily for days 91 and beyond. If you go past 60 “lifetime reserve days,” you’ll pay the full cost per day.

Medicare supplement (Medigap) and Medicare Advantage plans are two options available to fill the gaps in Original Medicare coverage.

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There is no requirement to buy supplemental insurance with Medicare. However, individual medical needs may mean you can benefit from a Medicare supplement like Medigap or coverage through Medicare Advantage. Some examples of people who can benefit from these alternatives include:

  • Those with international insurance needs
  • People who want extended hospital coverage
  • Prescription drug takers who could benefit from Medicare Advantage

Medicare Supplement: What Is Medigap?

When you sign up for Original Medicare, you can also purchase supplemental plans. Medigap is one such plan, often called Medicare supplement insurance. Traditional Medicare has several coverage gaps, including care-based gaps, cost coverage, co-insurance, copays, deductibles and out-of-pocket costs that aren’t covered, as well as international travel. Since supplement insurance is not available through the government, private insurers work to close those gaps with Medicare supplement coverage like Medigap plans.

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Medicare Supplement Plans

Medicare supplement plans are available through private carriers. They are labeled A–N, excluding vowels. Medigap plans A–D are not the same as Medicare plans. For instance, Medigap Plan A is not the same as Medicare Part A. Plans are standardized across all states except for Massachusetts, Minnesota and Wisconsin, which handle their plans differently.

Insurance companies don’t have to offer every plan, but they must offer at least Medigap Plan A, Plan C and Plan F. Rules have changed as of January 1, 2020. Plan B can no longer cover Medicare Part B deductibles for new enrollees. Because of this change, new beneficiaries can no longer purchase Plans C or F. If you were eligible for Medicare before the cutoff date, you may still be able to buy either Plan C or F.

The table below outlines each Medigap supplement plan. If there is a deductible, services aren’t covered until it’s met.

Medigap Plans
Medigap Supplement Plans
    * These plans are no longer offered to new enrollees.
    ** This is a high deductible plan in some states. The high deductible plan option includes a $2,700 deductible.
    *** Medigap will pay 100% of covered services for plans K and L after you meet your out-of-pocket yearly limit and Part B deductible.
    This pays 100% of the Part B co-insurance, with a copayment of up to $20 for some office visits and up to a $50 copayment for some ER visits.
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There are several things to consider when choosing a Medicare supplement plan. Insurers can use medical underwriting to determine your rate if you aren’t in a Medigap Open Enrollment Period or don’t have Medigap protections. Some providers offer discounts, such as multipolicy, paying annually or by electronic transfer or being a woman, married or a nonsmoker.

Other factors that may determine which Medicare supplement to choose include:

  • In-network physicians
  • International travel plans
  • Network flexibility
  • Overall lifestyle
  • Hospital choices

To be eligible for a Medigap plan, you must already be enrolled in both Medicare Parts A and B. Each Medigap plan is for an individual. Spouses will have to enroll in their own Medigap plan.

Medicare Part C: What Is Medicare Advantage?

If you decide Original Medicare with a Medigap supplement isn’t for you, Medicare Advantage is an alternative option. Also known as Part C, Medicare Advantage is available through private insurers. A Medicare Advantage plan is comparable to Original Medicare Parts A, B and D plans rolled into a single policy, though hospice care is not included.

Although there can be out-of-pocket fees for copays and co-insurance, Medicare Advantage imposes out-of-pocket maximums, which can benefit some plan holders. Dental, hearing and vision expenses, which aren’t included in Original Medicare, may also be available. Premiums for Medicare Advantage are relatively low, around $20 monthly, and are in addition to your $164.90 Medicare Part B premium (which can be higher, depending on income).

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Yes, you can switch from Medicare Advantage to Medigap. You can only buy Medigap if you are enrolled in Original Medicare Parts A and B, so you will have to drop Medicare Advantage.

If you switch plans, you could lose valuable guaranteed issue rights, including pre-existing condition waivers. You might also face provider-imposed penalties.

You can only switch at predetermined times throughout the year:

  • Within the first three months of Medicare enrollment
  • Open enrollment: January 1 – March 31
  • Annual Election Period: October 15 – December 7
  • Special Enrollment Periods: losing coverage, living situation changes, other enrollment opportunities and special situations

Cost of Medigap vs. Medicare Advantage

The cost of Medicare Advantage vs. Medigap can vary widely, from less than $100 to several hundred dollars monthly. Insurance providers can determine Medigap rates based on:

  • A single community price
  • The age you are when you get your plan (issue age)
  • Premium based on your attained age, which increases each year

Asking which premium method the insurer uses can help determine your cost, which doesn’t include your Original Medicare premiums. Your gender, location and plan choice will also factor into your Medigap premium.

Deductibles, like in Plans F and G, and copays, like in Plan N, may also factor into your out-of-pocket costs. Plans K and L have out-of-pocket limits, which may help keep out-of-pocket costs down.

Like Medicare supplement plans, Medicare Advantage rates can vary widely by plan, insurer and other factors. Premiums can be anywhere from $0 per month to over $100 per month, with an average of $18 monthly. Medicare Advantage costs are generally lower than Medicare Part B premiums, which start at $164.90 and are paid in addition to Medicare Advantage premiums.

There can be deductibles, copays and co-insurance to meet. Once you reach your Medicare Advantage out-of-pocket maximum — which can be high and varies by plan insurer — for the plan year, the insurer covers eligible expenses at 100%.

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Choosing between Medicare Advantage vs. Medicare supplemental insurance is a highly personal decision. Medicare Advantage is most beneficial for people who usually only seek regular medical care. Medigap may be a better fit for those needing more frequent medical attention, including costly services like surgeries.

Medigap vs. Medicare Advantage FAQs

Choosing between Medigap vs. Medicare Advantage depends on your individual needs, and you may have questions. Here are the answers to the most common questions asked about the topic.

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About Mandy Sleight, Licensed Insurance Agent

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Mandy Sleight is a licensed insurance agent and has worked in the industry since 2005. She has her property, casualty, life and health licenses. Mandy has worked for well-known insurance companies like State Farm and Nationwide Insurance, and most recently as the Operations Coordinator for a startup employee benefits company.

Mandy earned her Bachelor of Science degree in Business Administration and Management from the University of Baltimore and her Master of Business Administration from Southern New Hampshire University. She uses her vast knowledge of the insurance industry and personal finance combined with her writing background to create easy-to-understand and engaging content to help readers make smarter choices with their budgets and finances.