The Comparison in One Table
| What matters to you | Medicare Advantage | Supplement + Part D | Original Medicare + Part D only |
|---|---|---|---|
| Monthly cost | Often $0 plan premiumplus your Part B premium ($202.90) | Medigap premium + Part D premiumplus Part B | Part D premiumplus Part B |
| Cost when you use care | Copays and coinsurance for each service | Part B deductible ($283) then little or nothing on Plan G | 20% of everything, no limit |
| Yearly limit on what you pay | Yes — plan maximum, in-network | Effectively the Part B deductible (Plan G) | None |
| Doctor and hospital choice | Plan network (HMO/PPO) | Any provider accepting Medicare, nationwide | Any provider accepting Medicare |
| Referrals / prior authorization | Common | Rare | Rare |
| Drug coverage | Usually included | Separate Part D plan | Part D plan |
| Dental, vision, hearing | Often included | Separate plan | Separate plan |
| Travel within the U.S. | Emergency/urgent only (HMO); some PPO travel benefits | Full coverage anywhere | Full coverage anywhere |
| Changing your mind later | Can return to Original Medicare in enrollment windows; Medigap may require health questions | Can move to Advantage in any AEP | Can add either in windows; Medigap may require health questions |
| Who it tends to fit | Budget-focused, wants extras, care is local | Frequent care, wants freedom and predictability, travels | Very few people |
Three Questions That Usually Decide It
- Are your doctors in the networks available in your county? If the answer is no, Advantage is off the table regardless of price.
- What would a bad year cost you? Add up an Advantage plan's maximum out-of-pocket plus its premiums, and compare it with a year of Supplement + Part D premiums plus the Part B deductible. People are often surprised in both directions.
- Do you want to keep the Supplement option open? Your Medigap Open Enrollment window doesn't repeat. Starting with a Supplement keeps both doors open; starting with Advantage may close one.
A Note on Extras
Advantage extras (dental, OTC cards, gym) are real, but they are the most-changed benefits each year and the easiest to overvalue. Price the medical coverage first; treat extras as a tiebreaker. Stand-alone dental, vision and hearing plans exist for Supplement users.
Common Questions
Is Medicare Advantage or Medigap better?
Neither is better for everyone. Advantage usually costs less month to month and bundles extras, with networks and cost sharing when you use care. Medigap plus Part D costs more monthly, with near-total freedom of provider and very predictable costs. The right answer depends on your doctors, health, budget and travel.
Can I have both Medicare Advantage and a Medigap plan?
No. It's illegal for a company to sell you a Medigap policy while you're in a Medicare Advantage plan, and a Medigap policy won't pay toward Advantage plan costs.
What does Original Medicare alone leave me exposed to?
The Part A and Part B deductibles and 20% of Part B costs with no yearly cap, plus no drug coverage. That uncapped 20% is why nearly everyone adds either an Advantage plan or a Supplement.
