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Neither Medicare Advantage nor Original Medicare with Medigap is automatically cheaper. Medicare Advantage offers plan-specific cost sharing and a yearly limit on covered-service costs, but may restrict provider choice or require referrals and prior authorization. Original Medicare generally gives broader access to providers that accept Medicare; adding Medigap can help pay eligible Part A and Part B costs, in exchange for another premium. The right comparison depends on your doctors, prescriptions, expected care, local plan terms and whether you can obtain Medigap.
First, understand the two coverage routes
With Original Medicare, the federal program covers Part A hospital services and Part B medical services. You can add a separate Part D plan for prescription drugs and, if eligible to buy one, a Medigap policy to help with certain Part A and Part B deductibles, coinsurance or copayments.
Medicare Advantage (Part C) is an alternative way to receive Medicare-covered Part A and Part B benefits through a private plan. Many plans also include Part D. Medigap supplements Original Medicare; it does not pay Medicare Advantage plan copayments. You cannot use Medigap to supplement Medicare Advantage while enrolled in that plan.
What the 2026 baseline costs do—and do not—tell you
Medicare.gov publishes the following 2026 baseline amounts. They are not a personal quote: income-based Part B premiums, eligibility, plan terms and local Medigap prices can change what you pay.
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| Cost | 2026 amount | How to interpret it |
|---|---|---|
| Standard Part B premium | $202.90 per month | Medicare.gov’s 2026 standard premium; higher income-based premiums may apply. It generally remains due with Medicare Advantage as well as with Original Medicare. |
| Part B deductible | $283 | Medicare.gov’s 2026 deductible. |
| Part A inpatient hospital deductible | $1,736 per benefit period | Medicare.gov’s 2026 amount. It is per benefit period, not a once-per-year deductible; benefit periods can recur. |
| Part A premium | $0 per month for most people | Medicare.gov’s 2026 premium for people who qualify for premium-free Part A. Those who do not qualify may pay $311 or $565 per month, depending on work history. |
| High-deductible Medigap Plan F or G threshold | $2,950 | Medicare.gov’s 2026 threshold before a high-deductible Plan F or G pays covered costs. Availability varies. |
| Medigap annual out-of-pocket limit | Plan K: $8,000; Plan L: $4,000 | Medicare.gov’s 2026 limits for these standardized plans. |
Medicare Advantage premiums, copayments and out-of-pocket limits depend on the particular plan. Medigap premiums vary by policy, location and other factors. Use the current Medicare.gov plan comparison and local policy offerings to estimate your actual costs.
How to compare the costs fairly
Compare a full year’s expenses, not just the advertised premium. Include the Part B premium under either route. For Medicare Advantage, add any plan premium, deductibles, copayments or coinsurance, and prescription costs. For Original Medicare, add the Medigap premium if you buy a policy, a separate Part D premium, and your remaining medical and drug costs.
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- Estimate an ordinary year. List expected appointments, tests, procedures and prescriptions, then price them under the exact plan or policy terms.
- Stress-test a high-use year. Check the Medicare Advantage plan’s annual limit for covered services, including whether it has different in-network and out-of-network limits. Original Medicare alone has no annual out-of-pocket cap; Medigap can reduce some covered cost sharing but has its own premium and does not cover every service.
- Check drug costs separately. Compare your medications, doses, formulary tiers and pharmacy costs. Most Medicare Advantage plans include Part D, but verify the plan’s formulary. With Original Medicare, a separate Part D plan is generally needed; Medigap policies sold after 2005 do not include drug coverage.
A $0 Medicare Advantage plan premium does not mean Medicare coverage has no cost: the Part B premium generally remains due, and deductibles and service copayments may apply. A Medigap premium is an additional monthly expense, and the amount varies.
Coverage and access trade-offs
| Factor | Original Medicare with optional Medigap | Medicare Advantage |
|---|---|---|
| Doctors and hospitals | Generally, you can use any doctor or hospital that takes Medicare. Provider acceptance and assignment can affect costs. | Non-emergency care may be limited to a network or service area. Some plan types cover out-of-network care at higher cost; check the plan terms. |
| Referrals and prior authorization | Usually not required for covered services. | May be required under plan rules. |
| Medical cost sharing | Part A and Part B deductibles and coinsurance apply. For Part B-covered services, beneficiaries usually pay 20% of the Medicare-approved amount after the deductible, unless other coverage changes the amount. | Plan-specific deductibles, copayments and coinsurance, with an annual limit for covered health services under the plan’s terms. |
| Prescription drugs | A separate Part D plan is generally needed. Medigap policies sold after 2005 exclude prescription drug coverage. | Most plans include Part D; verify the formulary, pharmacy terms and drug costs. |
| Dental, vision and hearing | Original Medicare generally does not cover routine dental, vision or hearing aids. | A plan may offer extra benefits, but coverage limits and provider terms vary. |
| Travel | Original Medicare generally does not cover care outside the U.S. Some Medigap policies include limited foreign-travel emergency benefits. | Routine foreign care generally is not covered, though some plans may offer emergency or urgent travel benefits. |
Medigap enrollment and switching can change the decision
The federal Medigap Open Enrollment Period lasts six months. It starts the first month you are 65 or older and enrolled in Part B. During that period, insurers cannot deny you a policy or charge more because of pre-existing health problems. After the period, an insurer may not have to sell you a policy unless you have a guaranteed-issue right; a policy may also cost more. State rules may add or extend protections.
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1Repair Windows errors before they cause bigger problems2Scan for outdated or missing drivers - takes under a minute3Clear out junk files and repair common Windows errorsYou can leave Medicare Advantage for Original Medicare at permitted enrollment times, but switching does not automatically give you a right to buy Medigap. Medicare.gov describes trial rights, including a limited 12-month period for some people making a first-time transition, and other special rights. Which protection applies depends on your enrollment history and circumstances. Check your Medigap eligibility before you leave a plan or drop a policy.
The annual Open Enrollment period runs October 15 through December 7; accepted changes generally take effect January 1. The Medicare Advantage Open Enrollment Period has different eligibility and dates. If you move to Original Medicare, consider when to arrange separate Part D coverage as well as whether you can obtain Medigap.
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A practical checklist before choosing
- List your doctors, hospitals, specialists and pharmacies. Confirm Medicare acceptance or, for Medicare Advantage, network participation and any out-of-network terms.
- Write down each prescription and dosage. Compare formularies, tiers, preferred pharmacies and annual drug costs.
- Estimate premiums and cost sharing in both an expected-use year and a high-use year.
- For Medicare Advantage, verify the annual maximum and whether in-network and out-of-network limits differ.
- For Medigap, compare the standardized benefits and local premium, and include the cost of a separate Part D plan.
- Before switching, check federal guaranteed-issue or trial rights and any additional state protections.
Medicare.gov’s plan comparison can help you review local Medicare Advantage and Part D options. Your State Health Insurance Assistance Program (SHIP) can provide free, personalized counseling.
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