About 55% of Medicare beneficiaries now enroll in Medicare Advantage plans, according to KFF 2026 data, while the rest stay in Original Medicare, and many pair it with a Medigap (Medicare Supplement) policy. Both paths deliver Medicare-covered benefits, but the structure of your out-of-pocket costs, the providers you can see, and the extra benefits you access look very different depending on which route you take.
This guide compares Medigap and Medicare Advantage across the dimensions that matter most: cost predictability, provider access, supplemental benefits, and what happens when you need serious care. All cost figures reference 2026 CMS benchmarks.
Coverage Breakdown
| Feature | Original Medicare + Medigap | Medicare Advantage (Part C) |
|---|---|---|
| Monthly premium (2026) | Part B ($202.90) + Medigap Plan G (est. $80 to $300 depending on age and state) | Part B ($202.90) + MA plan premium (often $0 to $50) |
| Annual out-of-pocket cap (2026) | Near $0 after premium (Medigap Plan G covers nearly all cost-sharing) | Up to $9,250 in-network MOOP cap (2026 CMS limit) |
| Provider network | Any provider that accepts Medicare nationwide | HMO or PPO network (out-of-network may cost more or not be covered) |
| Prior authorization requirements | Generally none (Original Medicare sets coverage rules) | Common for specialist visits, hospitalizations, imaging, some drugs |
| Dental, vision, hearing benefits | Not included (Original Medicare excludes routine dental, vision, and hearing) | Often included; scope and dollar caps vary by plan |
| Prescription drug coverage | Requires a separate Medicare Part D standalone plan (PDP) | Usually bundled as an MAPD plan at no added premium |
| Enrollment / switching flexibility | Medigap: guaranteed issue only at Initial Enrollment; medical underwriting applies later in most states | Annual Election Period (Oct 15 to Dec 7); MA Open Enrollment Jan 1 to Mar 31, 2026 allows one plan switch |
Medigap Plan G is the most popular plan for new Medicare enrollees as of 2026. It covers the Part A hospital deductible ($1,736 in 2026), Part B coinsurance (20%), skilled nursing facility coinsurance, and foreign travel emergency care. The one gap is the Part B deductible ($283 in 2026), which beneficiaries pay once annually. Medicare Advantage MOOP figures reflect the 2026 CMS maximum allowed limit; actual plan MOOP may be lower.
Source: CMS Medicare Plan Finder 2026, CMS Medicare Advantage MOOP Final Rule 2026, KFF Medicare Advantage 2026 Enrollment Data
Direct Answer: Which Covers More?
It depends on your priorities. Medigap paired with Original Medicare covers more of your cost-sharing: after you pay the 2026 Part B deductible of $283, Plan G picks up virtually every covered Medicare expense for the rest of the year. Medicare Advantage covers more types of services by adding dental, vision, and hearing, but caps your financial protection at the 2026 in-network MOOP of up to $9,250. Neither option is universally superior.
How Original Medicare Plus Medigap Works in 2026
Original Medicare (Parts A and B) covers the bulk of hospital and medical services, but leaves significant cost gaps. Medicare Part A carries a 2026 inpatient deductible of $1,736 per benefit period. See Medicare free or cost for the full premium breakdown. Medicare Part B charges a 2026 annual deductible of $283, then 20% coinsurance on everything else with no annual cap. Without supplemental coverage, a serious illness could cost a beneficiary tens of thousands of dollars. Medigap policies fill these gaps.
Medigap Plan G, the most popular plan sold to new Medicare enrollees in 2026, covers the Part A deductible ($1,736 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency care up to policy limits. The only gap beneficiaries pay is the Part B deductible of $283 once per year. After that single annual payment, Plan G holders typically face $0 in claims cost-sharing for the rest of the year. Medigap Plan N offers a lower monthly premium with small office visit copays (up to $20) and emergency room copays ($50 when not admitted).
One critical caveat on Medigap: outside of your Initial Enrollment Period (the 6-month window starting when you turn 65 and enroll in Part B), most states allow insurers to use medical underwriting. Applying for Medigap later in life can result in coverage denial or higher premiums based on health status. Massachusetts, Maine, and New York are exceptions, requiring guaranteed issue year-round.
How Medicare Advantage Works in 2026
Medicare Advantage (Part C) plans are offered by private insurers under contract with CMS. They must cover everything Original Medicare covers, but they can structure cost-sharing differently and add benefits. In 2026, roughly 55% of Medicare beneficiaries are enrolled in Medicare Advantage, according to KFF, and most plans bundle prescription drug coverage (MAPD plans). The 2026 CMS rules set the maximum allowed in-network MOOP at $9,250. Individual plans often set their MOOP lower, but beneficiaries in plans that hit the cap can owe thousands before it kicks in.
Medicare Advantage plans frequently include supplemental benefits that Original Medicare excludes. Routine dental (cleanings, X-rays, extractions), routine vision (eye exams, frames, lenses), and hearing (exams, hearing aids) are offered by most plans in 2026, though dollar limits and covered services vary significantly by plan and county. Some plans also include fitness memberships (SilverSneakers and similar programs), telehealth, over-the-counter allowances, and transportation to medical appointments.
Prior authorization is the most common friction point in Medicare Advantage. Plans can require pre-approval for specialist visits, inpatient hospitalizations, imaging, durable medical equipment, and some Part D drugs. CMS strengthened prior auth rules for 2024 and 2026, requiring plans to respond faster and apply clinical criteria consistently, but prior auth remains more common in Medicare Advantage than in Original Medicare.
Cost Comparison: Real Numbers for 2026
The 2026 Part B standard premium is $202.90 per month for all Medicare beneficiaries, whether they choose Original Medicare plus Medigap or Medicare Advantage. That baseline applies to both paths. The difference is what comes on top. A Medicare Advantage plan with a $0 plan premium means total Medicare spending of roughly $202.90 per month before any claims, but out-of-pocket costs on claims can reach the 2026 MOOP cap of $9,250 in a bad year. Plan G Medigap premiums in 2026 typically run $80 to $300 per month for a 65-year-old depending on state and insurer, meaning total monthly cost of roughly $283 to $503 before any claims, but claims cost-sharing after the $283 Part B deductible is effectively zero for covered services.
For a beneficiary with few claims, Medicare Advantage can be significantly cheaper in total annual spend. For a beneficiary who needs surgery, extended hospitalization, or ongoing specialist care, Medigap often comes out ahead. The 2026 Part A inpatient hospital deductible of $1,736 per benefit period would be absorbed by Medigap Plan G but billed to a Medicare Advantage enrollee against their deductible and toward their MOOP.