Medicare Advantage vs. Medigap: How to Choose

By the Silverpoint Insurance advisory team · Updated September 23, 2026

The short answer

Medicare Advantage replaces Original Medicare with a private plan that usually has lower premiums, a provider network and extras like dental or OTC benefits. Medigap works alongside Original Medicare to cover out-of-pocket costs, usually with a higher premium but fewer bills and any doctor that accepts Medicare.

What is the main difference?

Medicare Advantage is an alternative way to get your Part A and B benefits through a private insurer. Medigap is a supplement that pays some of the costs Original Medicare leaves behind. You cannot use both at the same time.

Who tends to prefer Medicare Advantage?

People who want a low or $0 monthly premium, like having drug coverage and extras bundled into one plan, and are comfortable using a local network of doctors often lean toward Medicare Advantage.

Who tends to prefer Medigap?

People who want predictable costs, travel frequently in the U.S., or want to see any doctor who accepts Medicare without referrals often prefer Medigap paired with a separate Part D drug plan.

Can I switch later?

You can change Advantage plans during enrollment periods, but moving from Advantage to Medigap later may require health questions in many states. That's why the first decision around 65 matters.

Medicare Advantage vs. Medigap at a glance

FeatureMedicare AdvantageMedigap + Part D
Monthly premiumOften low; some $0Higher, plus a separate Part D premium
Out-of-pocket costsCopays up to a yearly maximumMostly covered depending on plan letter
Doctor choiceUsually a network (HMO/PPO)Any provider that accepts Medicare
Drug coverageOften includedSeparate Part D plan
Extras (dental, vision, OTC)Frequently includedGenerally not included
Travel in the U.S.Limited outside the networkCovered wherever Medicare is accepted

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Answers

Frequently asked

Clear, straightforward answers from a licensed advisor. If yours isn't here, we're a phone call away.

Is Medicare Advantage or Medigap cheaper?+
Advantage usually has lower premiums but more cost-sharing when you use care; Medigap has higher premiums but fewer bills. Total cost depends on your health and usage.
Do I still pay the Part B premium with Medicare Advantage?+
Yes. You generally continue paying your Part B premium with either option.
Related guides

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

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