Medicare Advantage (Part C) and Medigap (Medicare Supplement) are two different ways to fill the gaps left by Original Medicare. You can't have both at the same time. Here's how they compare.
Medicare Advantage is an all-in-one alternative to Original Medicare, sold by private insurers, that usually bundles hospital, medical, and often drug coverage into one plan with a network of providers.
Medigap is a supplemental policy you pair with Original Medicare to help cover out-of-pocket costs like copays, coinsurance, and deductibles. It requires you to have Original Medicare (Parts A and B) already.
| Medicare Advantage | Medigap | |
|---|---|---|
| Monthly premium | Often low or $0, plus your Part B premium | Fixed monthly premium, plus your Part B premium |
| Provider network | Usually restricted (HMO/PPO) | Any doctor who accepts Medicare, nationwide |
| Drug coverage | Often included | Not included — needs separate Part D |
| Extra benefits | Often includes dental, vision, hearing | Not included |
| Out-of-pocket costs | Annual out-of-pocket maximum, but copays per visit | Little to no out-of-pocket cost depending on plan letter |
| Referrals needed | Often yes, for HMO plans | No, never |
| Traveling coverage | Limited outside network/service area | Covered nationwide (and some emergency coverage abroad) |
| Underwriting after IEP | Not required | May require medical underwriting outside your Medigap Open Enrollment window |
Yes, but outside your initial Medigap Open Enrollment Period, insurers can use medical underwriting and may deny coverage or charge more based on your health.
Usually the monthly premium is lower, but out-of-pocket costs when you use care can be higher than with a comprehensive Medigap plan. Total cost depends on how much care you use.
Medigap does — you'll need a standalone Part D plan. Most Medicare Advantage plans include drug coverage already.
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