Medicare Advantage vs. Medigap: What's the Difference?

Original Medicare (Parts A & B) leaves gaps — copays, coinsurance, and no annual out-of-pocket cap. Medicare Advantage and Medigap both exist to address that, but they work in fundamentally different ways.

Medicare Advantage (Part C)

A Medicare Advantage plan replaces Original Medicare with a private plan that covers everything Parts A and B cover, often bundled with Part D drug coverage and extra benefits like dental, vision, or hearing. Plans typically use networks — HMO or PPO structures — meaning your choice of doctors may be more limited, and you'll often pay set copays for visits rather than a percentage of the cost.

Medigap (Medicare Supplement)

A Medigap policy works alongside Original Medicare rather than replacing it. It helps cover the out-of-pocket costs Original Medicare leaves behind — deductibles, copays, coinsurance — depending on which Medigap plan letter you choose. Medigap doesn't include drug coverage, so you'd pair it with a stand-alone Part D plan.

Key differences at a glance

• Provider access: Medigap generally works with any doctor accepting Medicare, nationwide. Medicare Advantage typically uses a network.
• Extra benefits: Medicare Advantage plans often include dental, vision, and hearing. Medigap does not.
• Drug coverage: Often bundled into Medicare Advantage. Medigap requires a separate Part D plan.
• Cost structure: Medicare Advantage often has lower premiums with copays at time of service. Medigap often has higher premiums with fewer costs when you actually receive care.
• Enrollment timing: Medigap medical underwriting rules can apply outside of specific enrollment windows, which is different from Medicare Advantage enrollment rules.

There's no universally "better" option

The right fit depends on how often you travel, whether you have specific specialists you want to keep seeing regardless of network, and how you'd rather structure your costs — smaller predictable copays, or a higher premium with fewer costs later. It's a personal calculation, not a one-size-fits-all answer.