Medicare Advantage vs. Medigap: Which Supplemental Coverage Makes Sense for You?

One of the most critical healthcare institutions in the United States, Medicare is a staple for many people seeking affordable medical help when retired. As part of the Medicare program, Medigap or Medicare Advantage are two supplemental policies that can boost your overall coverage options. 

Unfortunately, you can’t have both, so you have to choose between signing up for Medicare Advantage or Medigap. Ultimately, this means you have to choose between one or the other and consider all the factors involved, including which doctors you can see and how much each plan might cost you in the long and short term. 

What Medicare Covers

To understand why you might choose between Medicare Advantage and Medigap, you must consider what Medicare currently covers. Part A ensures hospital insurance coverage, while Part B covers your standard medical insurance. However, this leaves gaps with deductibles, copayments, and coinsurance, and there is no coverage for prescription drugs (Part D) and dental, vision, or hearing. 

As a result, you can purchase Medicare Advantage or Medigap to help you fill in any coverage gaps and end up with a more full-circle medical plan that covers most or all of your needs. 

What Is Medicare Advantage?

Known as Part C of Medicare, Medicare Advantage allows those currently enrolled in Medicare to enjoy the original Medicare plan from a private health provider, not the government. This generally includes choosing an HMO or PPO plan, which are the two most common options. 

Any plan under Medicare Advantage must match the same type of coverage as government-run Medicare. Still, it could be bundled with packages that original Medicare doesn’t cover, generally including prescription drug coverage. The biggest benefit of this plan is that it also likely offers vision, dental, and hearing benefits. On the con side, Medicare Advantage is accepted by fewer healthcare professionals and hospitals. 

What Is Medigap? 

If you choose to enroll in Medigap, you will receive an additional insurance policy from a private insurer in your state, and it is only a supplemental policy to Medicare. The purpose of Medigap is to provide the subscriber with any coverage “gaps” that original Medicare does not provide. 

This generally allows you to choose from one of ten Medigap plans, which will help you pay out-of-pocket costs that you receive from Medicare. However, it’s essential to know that Medigap doesn’t include long-term care, dental, vision, or hearing aids. 

Choosing Between Medicare Advantage and Medigap

Monthly Premiums

In 2025, the average cost of a Medicare Advantage plan is expected to be around $17 or 18 per month. Considering this includes additional dental, vision, and hearing coverage, this plan absolutely stands out as being very affordable. 

On the flip side, Medigap plans, which utilize private insurers, are expected to run between $65 and $450 monthly for coverage, depending on which of the 10 different Medigap plans you choose from and where you live. The benefit of paying this additional cost upfront is that out-of-pocket expenses are minimized when you receive care, so there is a hope it will occur.

However, with Medigap, you must consider your annual healthcare costs versus how much extra you will be paying even if you don’t have any additional medical care needs. 

Network Limits

Another primary consideration when choosing between these plans is what kind of network you are comfortable with. For all its advantages, Medicare Advantage has some flags around only allowing enrollees to use in-network providers. In the case of HMOs, you must have a referral from another doctor, which can be an annoyance. Alternatively, if you go with a PPO plan, you may have higher out-of-network costs should the need arise. 

In the case of the Medigap plan, you don’t have any actual network limits or restrictions. You can visit and receive care if a doctor or hospital accepts Medicare. Suppose you live in multiple states, such as those who snowbird between New York and Florida, this plan can be ideal, especially for retirees who don’t want to worry about finding new doctors. 

There is little question that having Medigap offers more flexibility in choosing healthcare providers. This is a good thing if you already have a doctor you have a good relationship with and want to continue using. If you go with Medicare Advantage, this doctor may not be in the network, which could force you to find another provider. 

Additional Benefits

One of the primary benefits of going with a Medicare Advantage plan that includes Part D is that medication coverage is included in your plan. On the other hand, if you have Medicare Advantage with Part D coverage, you don’t need to buy a standalone Part D plan, which would require a Part D premium, which means even more expenses coming out of your pocket every month.  

In the case of Medigap, the original Medicare doesn’t include Part D, so you will need to purchase a standalone plan to have any medicines covered. You must already factor in an additional Part D premium, which means you know your costs will go up with this plan. 

Key Factors to Consider

Health Needs

Anyone who is considering between these two options should have a good idea of what their individual health needs are. Medigap will be the better choice for anyone who needs frequent medical care as it offers lower out-of-pocket costs. Alternatively, Medicare Advantage can be sufficient if you are healthy and don’t frequently visit doctors except for annual checkups. 

Travel Preferences

Assume for a moment you are a frequent traveler. In this case, you want to consider that Medigap will offer nationwide coverage. This is a huge benefit you can’t ignore, and as long as you can find a medical facility that takes Medicare, you will be covered. 

If you have Medicare Advantage, you might struggle to find a local hospital or care service that takes your medical plan in case of an emergency. On the other hand, if you don’t stray far from home, Medicare Advantage may be adequate. 

Budget Constraints

Arguably, the most significant consideration between these two plans will focus heavily on your current budget situation. In the case of Medicare Advantage, the low cost of its premiums, which can reach as low as $0 per month, can be very appealing. The downside is that it comes with limits regarding network coverage (e.g., not every doctor is covered), but the cost is hard to ignore. 

The alternative is that Medigap has a higher cost, which can’t be ignored for those on a fixed income. Still, you receive private insurance benefits, meaning you have predictable medical expenses and a far more extensive medical network nationwide. 

Evaluating The Plans

Before you decide between Medicare Advantage and Medigap, consider all the coverage details available. This would include looking at both plans’ benefits, restrictions, and costs. Knowing the different premiums, copayments, out-of-pocket maximums, and deductibles is essential, as you don’t want any financial surprises throughout a calendar year. 

Separately, talk to your current doctor and confirm they are in network with Medicare Advantage. If not, then you know that Medicare Advantage may not be right for you unless you are okay with switching doctors. 

Last but not least, consider all of your future needs. Do you anticipate traveling more? Are you concerned about your overall health? The answer to these questions and those like them will help you make the most educated decisions between the plans. 

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