Medicare Advantage vs. Medigap: Which One’s Right for You?
Choosing between Medicare Advantage and Medigap (also called Medicare Supplement Insurance) is one of the most important decisions you’ll make when enrolling in Medicare. Both offer extra protection beyond Original Medicare—but they work very differently.
Quick Recap: Your Medicare Options
Once you enroll in Medicare Part A and Part B, you have two paths:
- Option 1: Stick with Original Medicare and add a Medigap plan (Medicare Supplement) and optional Part D drug coverage
- Option 2: Choose a Medicare Advantage plan (Part C), which replaces Original Medicare and often includes drug coverage
You can’t have both a Medigap plan and a Medicare Advantage plan at the same time.
What Is Medicare Advantage?
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They bundle Part A, Part B, and usually Part D into one plan.
Key features:
- May include extra benefits like dental, vision, hearing, and gym memberships
- Often have lower premiums, but require copays and coinsurance
- Use provider networks—like HMOs or PPOs
Example:
Mary joins a Medicare Advantage HMO with a $0 premium, $3,500 out-of-pocket max, and free dental cleanings. But she must stay in-network and get referrals for specialists.
What Is Medigap?
Medigap plans help cover costs that Original Medicare doesn’t—like deductibles, copays, and coinsurance.
Key features:
- No provider networks—see any doctor that accepts Medicare nationwide
- More predictable out-of-pocket costs
- Requires adding a separate Part D drug plan
Example:
John enrolls in Original Medicare + Medigap
Plan G + a Part D plan. He pays higher monthly premiums but has very low out-of-pocket costs and full provider freedom.
| Medicare Advantage | Medigap + Original Medicare | |
|---|---|---|
| Monthly Premiums | Generally Lower but has copays | Higher premiums but no copayss |
| Doctor Choice | Network required | Any Medicare provider |
| Drug Coverage | Usually included | Must add separately |
| Extra Benefits | May include (dental, vision, etc.) | Rare |
| Out-of-Pocket Costs | Pay as you go | Minimal with Plan G/N |
| Travel Flexibility | Emergency services only outside service area | Nationwide coverage |
| Referrals | May need referrals for specialist | No referrals necessary |
Can I switch between the two?
Yes—but timing matters. If you drop a Medigap plan for a Medicare Advantage plan, you might not be able to get the Medigap plan back later without underwriting.
Is one option better for frequent travelers?
Medigap is usually better for people who travel frequently, since there are no networks or service area limits.
Are dental and vision covered?
Medicare Advantage plans often include extras like dental or vision. Medigap plans don’t—though you can buy separate coverage.
Which has lower out-of-pocket costs?
It depends. Medicare Advantage often has lower premiums, but more cost-sharing. Medigap plans have higher premiums but lower costs when you use services.
Can I use Medigap with an Advantage plan?
No. It’s one or the other—not both.
Ready to compare plans?
Contact us for a free one-on-one consultation. We’ll help you make the right decision with confidence.
The right choice depends on what matters most to you:
- Prefer flexibility and low out-of-pocket surprises? Medigap might be better.
- Want bundled extras and lower premiums? Medicare Advantage may be the way to go.
At Benedict Health Advisors, we help people across Richmond, Centerville, Cambridge City, and Connersville compare real plans, based on real needs—not guesswork.