Medicare choices

Medicare Advantage vs. Medigap: the difference, the costs and the warning to read first

Figures as of October 12, 2026
By Ask Margaret, reviewed by a person
Margaret is an AI host

Both are real Medicare, and neither is better for everyone. This guide explains the difference in plain terms, shows what each costs in 2026, and gives you the one warning to read before you give up a Medigap policy. It does not tell you which to pick. Only you can weigh your doctors, drugs and budget.

Figures as of October 2026. Open Enrollment runs October 15 to December 7, 2026. Changes start January 1, 2027.

Medicare open enrollment 2027: 4 things to check before December 7Watch on YouTube. The video goes live on October 15, 2026.

What is the difference between Medicare Advantage and Medigap?

Medicare Advantage (Part C) is a private plan that replaces Original Medicare for your Part A and B coverage, usually with drug coverage included. Medigap is a private policy that works alongside Original Medicare and pays some of the costs Medicare leaves, like deductibles and coinsurance. You cannot use Medigap with a Medicare Advantage plan.

So the real choice is between two paths: Original Medicare (often with a Medigap policy and a separate Part D drug plan), or a Medicare Advantage plan. Source: Medicare.gov, compare Original Medicare and Medicare Advantage.

What does Original Medicare cover?

Original Medicare is run by the federal government. Part A covers hospital stays and some other care. Part B covers doctor visits, outpatient care and many tests and supplies. You pay a monthly Part B premium, a yearly deductible and usually 20% of the cost of most services. It does not cover most pharmacy drugs.

You can go to any doctor or hospital in the United States that accepts Medicare, and you usually do not need a referral. Original Medicare has no yearly limit on what you could pay, which is why many people add a Medigap policy or have other coverage. For drugs, you can add a separate Part D plan.

What is a Medicare Advantage plan?

A Medicare Advantage plan is sold by a private insurer that contracts with Medicare. It gives you almost all of your Part A and Part B benefits, and most plans include drug coverage. Plans set their own copays and rules, most use a network of doctors, and each has a yearly limit on what you could pay for covered services.

You still pay your Part B premium, and some plans charge their own premium too, which may be $0. Many plans add dental, vision or hearing. Medicare.gov says Original Medicare still helps with hospice care and some clinical trial costs. Source: Medicare.gov, Understanding Medicare Advantage Plans.

How do they compare side by side?

The biggest differences are doctor choice, approvals, cost limits and drug coverage. Original Medicare lets you see any doctor that accepts Medicare, with few approvals and no yearly cost limit. Medicare Advantage usually uses a network, may require approvals, and caps what you pay in a year.

Original Medicare and Medicare Advantage, side by side
	Original Medicare	Medicare Advantage
Who runs it	Federal government	Private insurer approved by Medicare
Doctors	Any that accept Medicare	Usually a plan network
Referrals	Usually none	Some plan types require them
Approval before care	Few services	More services may need approval
Yearly cost limit	None	Yes, set by each plan
Drug coverage	Add a separate Part D plan	Usually included
Dental, vision, hearing	Mostly not covered	Often included, with limits
Travel	Covered across the U.S.	Depends on plan; check out-of-area rules
Extra premium	Medigap, if you buy it	Some plans have a $0 plan premium

Adapted from Medicare.gov's comparison page, as of October 2026.

What does Medigap cover?

Medigap, also called Medicare Supplement Insurance, is a private policy that helps pay costs Original Medicare leaves, such as deductibles and coinsurance. It works with Original Medicare only. It does not cover prescription drugs for plans sold after 2005, so you would need a separate Part D plan. One policy covers one person.

Plans are labeled with letters. Plans with the same letter offer the same basic benefits no matter which company sells them. Massachusetts, Minnesota and Wisconsin standardize Medigap in a different way.
Prices for the same letter vary by company.
Medigap premiums are in addition to your Part B premium.
Medicare.gov says a Medigap policy cannot pay your Medicare Advantage copays, deductibles, coinsurance or premiums.

To compare policies, use the free official tool: Medicare.gov, find a Medigap policy. Your SHIP can also help you compare policies in your state. Source: Medicare.gov, Choosing a Medigap Policy.

What does Original Medicare cost in 2026?

In 2026, the standard Part B premium is $202.90 a month, the Part B deductible is $283, and the Part A deductible is $1,736 per hospital benefit period. After the Part B deductible you usually pay 20% of the Medicare-approved amount. Premiums are higher with higher income. 2027 figures are not announced yet.

Original Medicare costs, 2026 (Medicare.gov, as of October 2026)
Item	2026 amount
Part B standard monthly premium	$202.90 (higher with higher income)
Part B yearly deductible	$283
Part A deductible per hospital benefit period	$1,736
Part B coinsurance for most services	20% of the Medicare-approved amount, after the deductible

Medicare.gov says 2027 coverage and costs are released in the fall, so check Medicare.gov before you decide. Medicare Advantage premiums, copays and limits are set by each plan. Your 2027 numbers are in the plan's Annual Notice of Change and on the Medicare Plan Finder. If your income is limited, you may get help paying these costs: see our Medicare Savings Programs guide.

How do drug costs work in each path?

Part D drug plans, and Medicare Advantage plans with drug coverage, have a yearly cap on what you pay out of pocket for covered drugs: $2,100 in 2026 and $2,400 in 2027. After you reach it, you pay nothing for covered Part D drugs for the rest of the calendar year. Your plan premium is separate.

Original Medicare does not include drug coverage, so you add a Part D plan. Most Medicare Advantage plans include it. Drug lists, tiers and pharmacies differ by plan and change every year, so enter your own drugs when you compare. Source: Medicare.gov, Part D costs, as of October 2026.

What is the Medigap warning to read before switching?

Medicare gives you a one-time 6-month Medigap Open Enrollment Period when you first have Part B at 65 or older, when insurers cannot turn you down or charge more for health. After that, in most states, a Medigap insurer can ask health questions and say no. So leaving Medigap for Medicare Advantage can be hard to undo.

If you drop Medigap, join Medicare Advantage, and later want Original Medicare with a Medigap policy again, then in most states you may be turned down or charged more because of your health history. Medicare.gov describes a limited "trial right": if you dropped a Medigap policy to join Medicare Advantage for the first time, you may be able to get your old policy back within the first year if the same company still sells it. Conditions apply, and some states give more rights than federal law.

Before you drop Medigap:

Call your SHIP (free) and ask: "In my state, if I leave Medigap for Medicare Advantage and want to come back, could the insurer say no?"
Do not cancel your Medigap policy until your new plan is confirmed and has started. Medicare.gov says that once you cancel a Medigap policy, in most cases you cannot get it back.
Write down the answers and the name of the person you spoke with.

This is not a reason to stay or to leave. It is a reason to ask before you act. Sources: Medicare.gov, when can I buy a Medigap policy; Medicare.gov, switching or dropping a Medigap policy.

When can I switch?

Open Enrollment runs October 15 to December 7 each year. You can join, drop or switch Medicare Advantage and Part D plans, and changes start January 1. If you are in a Medicare Advantage plan, you also get January 1 to March 31, with one change allowed, to switch plans or return to Original Medicare.

The January to March period is only for people already in Medicare Advantage. You cannot use it to move from Original Medicare to a Medicare Advantage plan. Life events, such as moving out of your plan's area or losing other coverage, can open a special enrollment period. If you have Medicaid or Extra Help, you can make a change once per calendar month. Sources: Medicare.gov, enrollment periods; Medicare.gov, key dates.

What should I ask before choosing a plan?

Ask six questions and write down the answers: Are my drugs covered, and at what tier? Are my doctors in the network? What is my total yearly cost? What needs approval first? What about travel? How could I leave later? If no one can answer clearly, treat that as an answer.

Drugs. Are all my drugs on the plan's list for 2027, and what tier is each?
Doctors. Are my doctors, specialists and hospital in the network for 2027? Ask the doctor's office too.
Total cost. Add premium, deductible, copays and the most I could pay.
Approvals. What needs approval first: tests, surgeries, any drug I take?
Travel. What happens if I travel or spend part of the year in another state?
Leaving. If I do not like the plan, how and when can I leave, and could I get back what I have now?

Where can I get free, objective help?

Your State Health Insurance Assistance Program (SHIP) gives free, local, objective counseling on Medicare, including Medigap and Open Enrollment. You can also call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) or compare plans on the official Medicare Plan Finder. You never need to pay anyone for Medicare help.

SHIP: shiphelp.org
Plan Finder: medicare.gov/plan-compare
Medicare will never call you to sell you anything. See Medicare.gov, reporting fraud.

Frequently asked questions

Can I have Medicare Advantage and Medigap at the same time?

No. Medigap works only with Original Medicare. Medicare.gov says a Medigap policy cannot pay your Medicare Advantage copays, deductibles, coinsurance or premiums.

Does Medigap cover prescription drugs?

No. Medigap plans sold after 2005 do not include drug coverage. If you have Original Medicare with Medigap, you need a separate Part D drug plan.

Which is cheaper, Medicare Advantage or Medigap?

It depends on how much care you use. Some Medicare Advantage plans have a $0 plan premium, but you still pay your Part B premium and the plan's copays, up to its yearly limit. Medigap adds a monthly premium on top of Part B. Compare your total yearly cost, not just the premium.

Can I switch from Medicare Advantage back to Original Medicare?

Yes. You can switch during Open Enrollment, October 15 to December 7, or during the Medicare Advantage Open Enrollment Period, January 1 to March 31, when you may make one change. Getting a Medigap policy afterward is not guaranteed in most states, so ask your SHIP first.

Can a Medigap company turn me down?

In most states, yes, after your 6-month Medigap Open Enrollment Period ends. During that period, which starts the first month you are 65 or older and have Part B, insurers cannot turn you down or charge more because of your health.

Do all Medigap plans with the same letter cost the same?

No. Plans with the same letter offer the same basic benefits, but the price varies by company. Massachusetts, Minnesota and Wisconsin standardize Medigap in a different way.

When is Medicare Open Enrollment in 2026?

October 15 to December 7, 2026. Changes you make start January 1, 2027. Your plan must receive your request by December 7.

Where can I get free help choosing?

Your State Health Insurance Assistance Program (SHIP) offers free, local, objective counseling. You can also call 1-800-MEDICARE at 1-800-633-4227.

Sources

Figures are as of October 2026, from the Medicare.gov pages below. Rules and costs change, so check the page before you rely on a number.

Compare Original Medicare and Medicare Advantage. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
Understanding Medicare Advantage Plans. https://www.medicare.gov/publications/12026-understanding-medicare-advantage-plans.pdf
Choosing a Medigap Policy. https://www.medicare.gov/publications/02110-choosing-a-medigap-policy.pdf
Find a Medigap policy. https://www.medicare.gov/medigap-supplemental-insurance-plans/
When can I buy a Medigap policy?. https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
Switching or dropping a Medigap policy. https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop
Medicare costs (2026 premiums and deductibles). https://www.medicare.gov/basics/costs/medicare-costs
Part D costs (2026 and 2027 out-of-pocket cap). https://www.medicare.gov/health-drug-plans/part-d/basics/costs
Enrollment periods for Medicare Advantage and drug plans. https://www.medicare.gov/publications/11219-Understanding-Medicare-Advantage-Medicare-Drug-Plan-Enrollment-Periods.pdf
Remember key Medicare dates. https://www.medicare.gov/publications/12192-remember-key-medicare-dates.pdf
Reporting Medicare fraud and abuse. https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse

Want the whole thing in one guide? Our longer Medicare Choices Guide for Open Enrollment is coming soon. Sign up for the free checklist above and we will tell you when it is ready.

General education only, not insurance, financial, tax, legal or medical advice. Ask Margaret is not affiliated with, endorsed by, or part of Medicare, CMS, the Social Security Administration or any government agency. We do not sell insurance or Medicare plans and do not recommend any plan.