If you're turning 65 or reviewing your Medicare options for 2026, the biggest choice you'll face is this: Medicare Advantage or Medigap (also called Medicare Supplement)? Both build on Original Medicare (Parts A and B), but they work completely differently. The right pick depends on your health, your finances, and where you live.
Quick Answer: Medicare Advantage bundles hospital, medical, and often drug coverage into one plan with low premiums but copays each time you use care. Medigap pays your Medicare cost-sharing (deductibles, copays, coinsurance) and pairs with a separate Part D drug plan. As of 2026, Medicare Advantage plans average around $14/month but carry a $9,250 in-network out-of-pocket maximum. Medigap Plan G averages $120 to $250/month with predictable, near-zero cost-sharing after the $283 Part B deductible.
You cannot have both at the same time. Choosing one means giving up the other, so it pays to understand both thoroughly before committing.
What Is Medicare Advantage?
Medicare Advantage (Part C) is offered by private insurance companies approved by Medicare. You enroll through a plan rather than using Original Medicare directly. The plan receives a fixed monthly payment from CMS to cover your care.
Most Advantage plans include:
- Part A (hospital) coverage
- Part B (medical) coverage
- Part D (prescription drugs) -- usually bundled in
- Extra benefits: dental, vision, hearing, fitness programs, over-the-counter allowances, and medical transportation
You still pay the Part B premium ($202.90/month in 2026) even on a Medicare Advantage plan. Most plans charge an additional premium on top of that, though many $0-premium plans exist in competitive markets. In return, you pay copays and coinsurance each time you use services.
The critical number to understand: Medicare Advantage plans have a yearly out-of-pocket maximum. In 2026, that cap is $9,250 for in-network care and $13,900 for combined in-network and out-of-network care. Once you hit the cap, the plan covers 100% for the rest of the year.
Most Advantage plans are HMOs or PPOs. HMOs require you to use a specific network of doctors and get referrals to see specialists. PPOs are more flexible but cost more to use out of network.
What Is Medigap (Medicare Supplement)?
Medigap is supplemental insurance sold by private insurers to fill the gaps in Original Medicare. You keep Original Medicare and use it as your primary insurance. Medigap then steps in and pays some or all of what Medicare does not cover.
For 2026, the most relevant Medigap plans for new enrollees are Plan G and Plan N. Plan F is no longer available to people who became eligible for Medicare on or after January 1, 2020.
Plan G covers:
- Part A deductible ($1,736 in 2026)
- Part A coinsurance and hospital costs
- Part B coinsurance and copays
- Part B excess charges
- Skilled nursing facility coinsurance
- Foreign travel emergency (80%, up to plan limits)
Your only out-of-pocket expense with Plan G in 2026 is the $283 Part B deductible, paid once per year.
Plan N covers the same items as Plan G except Part B excess charges. You also pay up to $20 per office visit and up to $50 for emergency room visits that don't result in an inpatient admission. Premiums are lower as a tradeoff.
Medigap does not cover prescription drugs, so you need a separate Part D drug plan. Part D plans average around $34.50/month in 2026, which adds to your total monthly cost.
2026 Cost Comparison Side by Side
| Cost Factor | Medicare Advantage | Medigap Plan G | Medigap Plan N |
|---|
| Part B premium (required) | $202.90/mo | $202.90/mo | $202.90/mo |
| Plan premium | $0 to ~$100/mo | $120 to $250/mo | $80 to $200/mo |
| Part D drug coverage | Usually bundled | Separate (~$34.50/mo) | Separate (~$34.50/mo) |
| Part B deductible | Varies by plan | $283/year | $283/year |
| Copays/coinsurance | Yes, each visit | None (after deductible) | $20 office, $50 ER |
| Part B excess charges | Not covered | Covered | Not covered |
| Annual out-of-pocket max | $9,250 in-network | No cap, but predictable | No cap, but predictable |
| Network restrictions | Usually yes (HMO/PPO) | No -- any Medicare provider | No -- any Medicare provider |
| Foreign travel coverage | Rarely | Yes (Plan G includes it) | Yes (Plan N includes it) |
Enrollment Rules and Timing
The timing of when you enroll matters a lot for Medigap.
Medigap Open Enrollment Period: This is a one-time 6-month window that starts the first day of the month you turn 65 and are enrolled in Part B. During this window, insurers must sell you any plan they offer and cannot reject you or charge more based on pre-existing conditions. Miss this window and you may face medical underwriting -- insurers can deny you coverage or charge significantly higher premiums based on your health history.
Medicare Advantage Enrollment: You can join or switch Advantage plans during Annual Enrollment (October 15 to December 7 each year) for coverage starting January 1. You can also switch during the Medicare Advantage Open Enrollment Period (January 1 to March 31). When you first become eligible for Medicare, you have an Initial Enrollment Period to sign up.
Important: If you enroll in Medicare Advantage and later want to switch to Medigap, you may not be able to get the Medigap plan you want. Insurers in most states can deny you or charge more based on health. Only a handful of states (including Connecticut, Maine, Massachusetts, and New York) require guaranteed issue rights for Medigap regardless of when you apply.
Network and Provider Access
This difference is significant and often overlooked.
With Medigap, you can see any doctor or hospital that accepts Medicare, anywhere in the country. There are no networks, no referral requirements, and no prior authorization for most services. If you travel frequently, live part of the year in different states, or want to see specialists at major medical centers, Medigap eliminates those obstacles.
With Medicare Advantage, you typically use a plan network. HMO plans generally require a primary care referral to see a specialist. PPO plans allow out-of-network care but at higher cost-sharing. If you split your time between two states, check carefully whether both areas are in-network before enrolling.
Extra Benefits: Medicare Advantage's Edge
One area where Medicare Advantage clearly wins is extra benefits. Original Medicare (and Medigap paired with it) covers essentially no dental, vision, or hearing care.
Many Medicare Advantage plans in 2026 include:
- Routine dental (cleanings, X-rays, some restorative work)
- Vision exams and an annual allowance for glasses or contacts
- Hearing exams and hearing aid benefits
- Fitness memberships (SilverSneakers or similar)
- Over-the-counter allowances for health-related items
- Transportation to medical appointments
The value of these extras varies widely by plan and by how much you actually use them. A dental benefit worth $1,500/year is valuable if you use it; worth nothing if you don't.
Who Should Choose Medicare Advantage?
Medicare Advantage tends to work better if you:
- Are generally healthy and use minimal healthcare services
- Want low or $0 monthly premiums beyond Part B
- Value bundled drug coverage (no separate Part D enrollment)
- Use the extra benefits (dental, vision, hearing) regularly
- Live and receive care primarily in one location within a plan's network
- Are comfortable with copays at time of service rather than higher premiums upfront
Who Should Choose Medigap?
Medigap tends to work better if you:
- Have ongoing health conditions or chronic illnesses requiring frequent care
- Want predictable costs with no surprise bills
- Travel frequently or split time between multiple states
- Want to see any Medicare-accepting specialist without referrals or network restrictions
- Are willing to pay higher monthly premiums in exchange for lower unpredictable costs
- Are enrolling during your Medigap Open Enrollment Period (before health issues arise)
A Real-World Example
Imagine you have a knee replacement in 2026. The procedure involves a hospital stay, surgery, physical therapy, and follow-up visits.
Under Medicare Advantage: You pay your plan's copays and coinsurance for each component until you hit the $9,250 out-of-pocket max. For someone with a typical HMO plan, this might mean $250 inpatient copay per day for the first few days, 20% coinsurance on the surgeon, physical therapy copays of $30 to $50 per visit, and related outpatient costs.
Under Medigap Plan G: After paying the $283 Part B deductible once this year, Medicare covers 80% of approved costs and Plan G covers the remaining 20%. Your hospital stay under Part A is fully covered after Medicare applies its rules. Physical therapy and follow-up visits have no copay. Your total cost is likely under $500 for the entire episode.
The Medigap route often wins for major health events. The Advantage route often wins for healthy years with few medical needs.
What About Prescription Drugs?
Medicare Advantage plans usually bundle Part D drug coverage into the same plan. You do not need to enroll separately.
With Medigap, you need a standalone Part D Prescription Drug Plan. This adds a separate monthly premium (averaging around $34.50 in 2026) and means managing a second card and a second set of rules for formularies and pharmacy networks.
The drug coverage quality varies widely between plans. Whether you use Advantage or a standalone Part D plan, compare your specific medications against each plan's formulary before enrolling.
How to Check Your Options
Plan availability and pricing differ by zip code. A Plan G premium of $150/month in one city might be $210/month 50 miles away. Medicare Advantage plan networks and extra benefits also vary significantly by region.
The best starting point is to check your eligibility and get matched to the plans actually available where you live. Check your Medicare eligibility at coveredusa.org to see what options apply to your situation. From there, you can work with a licensed agent who can compare the specific plans and premiums in your area at no cost to you.
Check your eligibility now at CoveredUSA -- it takes 2 minutes.
Frequently Asked Questions
Can I switch from Medicare Advantage to Medigap later?
You can technically disenroll from Medicare Advantage and go back to Original Medicare during enrollment periods. However, in most states, Medigap insurers can then apply medical underwriting and deny you coverage or charge higher premiums based on your health. The exceptions are a few states with guaranteed issue rights year-round (Connecticut, Maine, Massachusetts, New York). If you think you may want Medigap eventually, enrolling during your initial open enrollment window gives you the strongest protections.
Do I need Part D if I have Medigap?
Yes. Medigap does not cover prescription drugs. You need a standalone Part D Prescription Drug Plan to avoid the Part D late enrollment penalty. The penalty is 1% of the national base beneficiary premium per month you went without creditable drug coverage, and it applies permanently.
Which Medigap plan is most popular in 2026?
Plan G is the most popular Medigap plan for new enrollees in 2026. Plan F was the historical leader but closed to new enrollees in 2020. Plan G offers near-identical coverage to Plan F (the only difference is Plan G does not cover the Part B deductible, which is $283 in 2026). Plan N is the second most popular option for people who want lower premiums and are willing to absorb modest copays.
What is the Part B premium in 2026?
The standard Part B premium is $202.90 per month in 2026, up from $185.00 in 2025. Higher-income beneficiaries pay more through IRMAA surcharges. You pay this premium regardless of whether you have Medicare Advantage or Medigap.
Can I have both Medicare Advantage and Medigap at the same time?
No. Federal law prohibits insurers from selling you a Medigap policy if you are enrolled in a Medicare Advantage plan. You must choose one or the other. Some people buy Medigap and then later switch to Advantage (or vice versa), but the switch carries risks related to underwriting in most states.
How does the Medicare Advantage out-of-pocket maximum work in 2026?
In 2026, Medicare Advantage plans can charge no more than $9,250 per year for in-network services and $13,900 for combined in-network and out-of-network care. Once you reach this limit, the plan covers 100% of covered services for the rest of the calendar year. The limit resets each January 1. Note that individual plans may set their own caps below the federal maximum, so check your specific plan's Summary of Benefits.
Is Medicare Advantage cheaper than Medigap?
It depends on how much care you use. Medicare Advantage typically has lower or $0 monthly premiums, making it cheaper in years when you are healthy and use little healthcare. Medigap has higher monthly premiums but low or no cost-sharing at time of service. For people with chronic conditions or who need frequent care, Medigap often costs less over the course of a year despite the higher premiums.
What is a Medicare Advantage HMO vs PPO?
An HMO (Health Maintenance Organization) requires you to use a specific network of doctors and hospitals, typically get referrals from a primary care doctor to see specialists, and in most cases does not cover out-of-network care except in emergencies. A PPO (Preferred Provider Organization) allows you to see any provider but costs less when you stay in-network. PPO plans generally have higher premiums than HMO plans. Neither restricts you to a network if you have Medigap instead.
