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Medicare Advantage and Medigap do not have one universal price winner. Medicare Advantage can have a $0 plan premium and usually bundles prescription coverage, but you pay the Part B premium and face plan-specific deductibles, copayments, coinsurance, networks and prior-authorization rules. Original Medicare paired with Medigap requires a separate Medigap premium and usually a separate Part D premium, but the policy pays specified Original Medicare cost sharing and generally lets you use any provider that accepts Medicare. Your lower-cost choice depends on your ZIP code, available plans, prescriptions, doctors and hospitals, expected care and tolerance for variable bills. Compare a full year of premiums and likely out-of-pocket costs—not the advertised plan premium alone.
The comparison below uses Medicare rules and plan information available for the 2026 plan year. Prices and availability change by location and insurer, so treat the result as a method for making your own local comparison.
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At a glance
| Name | Best for | Key spec | Free plan / price | Checked |
|---|---|---|---|---|
| Medicare Advantage | People who want one plan for medical and usually drug coverage, accept a network and want an annual limit on covered Medicare services | Plan-specific deductibles, copays, coinsurance, network and prior authorization; annual limit for covered Medicare services | Plan premium may be $0 or more; Part B premium still applies | November 2026 |
| Original Medicare + Medigap | People who value broad provider access and more predictable cost sharing and can budget recurring premiums | Medigap pays specified Part A and Part B cost sharing; separate Part D generally needed for drugs | Part B premium plus a separate Medigap premium and usually a Part D premium | November 2026 |
Prices checked November 2026.
Medicare.gov’s coverage comparison explains the basic trade-off: Medicare Advantage is private-plan coverage that replaces Original Medicare for covered services, while Medigap supplements Original Medicare. You cannot use Medigap to pay Medicare Advantage cost sharing.
Which option is cheaper for most retirees?
Neither option is reliably cheaper for every retiree. A Medicare Advantage plan with a $0 premium can still cost more over a year if you have frequent visits, expensive outpatient services, hospital care, high drug costs or out-of-network needs. Conversely, a Medigap policy’s monthly premium can exceed the medical cost sharing you would have paid in a low-use year, especially after adding a Part D premium.
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The right comparison is an annual, location-specific estimate. Include premiums, medical cost sharing, prescriptions, access restrictions and the value of benefits you would otherwise purchase. Then run both a routine-use scenario and a high-use scenario. A plan that looks cheaper for ordinary appointments may be less attractive if a serious illness pushes you toward its annual medical out-of-pocket limit.
How do the premiums and cost sharing differ?
Both choices generally require the Medicare Part B premium, and Part A may also have a premium for people who do not qualify for premium-free Part A. The differences are what you buy beyond those base costs.
Medicare Advantage
- You pay the plan’s premium, which may be $0 or more, in addition to Part B.
- The plan sets deductibles, copayments and coinsurance for covered services. The amount can differ for primary-care visits, specialists, imaging, therapy, emergency care, inpatient stays and other services.
- The plan has a yearly out-of-pocket limit for covered Medicare services. The limit and the charges that count toward it are plan-specific. Prescription expenses follow the plan’s Part D rules and should be calculated separately.
- Some plans include dental, vision or hearing benefits, but those benefits have their own limits, networks or allowances.
Original Medicare with Medigap
- You continue paying Part B and add a Medigap premium. If you want outpatient prescription coverage, you generally add a separate Part D plan and its premium.
- Medigap covers specified Part A and Part B deductibles, copayments or coinsurance according to the plan letter. Amounts the policy does not cover remain your responsibility.
- Original Medicare does not have a general annual out-of-pocket limit. Medigap can reduce specified medical cost sharing, but it does not turn every service into a covered service and its premium is payable even when you use little care.
- Medigap policies sold after 2005 do not include drug coverage. Routine dental, vision, hearing aids and long-term care generally are not covered by Medigap.
Medicare.gov warns that “Medigap premiums vary widely depending on the insurance company, the plan, and where you live.” The same principle applies to Medicare Advantage premiums and cost sharing: use the specific plan documents for your county rather than a national average.
What should you include in a fair annual cost comparison?
Use one calendar year and identical assumptions for both options. A worksheet with the following categories prevents the common mistake of comparing a single premium with a collection of unknown costs.
- Base Medicare premiums. Enter the Part B premium for the year you are comparing and any applicable Part A premium. These costs generally continue under either route.
- Plan premiums. Add the Medicare Advantage premium, or add the Medigap premium plus the separate Part D premium for an Original Medicare strategy. If a plan has a deductible or other fixed charge, record it separately.
- Expected medical services. List your likely primary-care and specialist visits, laboratory work, imaging, therapy, durable medical equipment, emergency care and hospital services. Apply each plan’s stated copayment, coinsurance and deductible.
- Prescriptions. Enter every medication, dose, quantity and preferred pharmacy in Medicare.gov’s plan comparison. Use the plan’s formulary, tiers, deductible and pharmacy network rather than a generic drug estimate.
- High-use protection. For Medicare Advantage, model a year in which covered medical services approach the plan’s annual out-of-pocket limit. Do not treat that limit as a cap on premiums, noncovered care or every prescription expense.
- Access-related costs. Account for out-of-network rates, referrals, prior authorization and travel to an in-network facility. Under Original Medicare, verify that each doctor and hospital accepts Medicare and whether they accept assignment.
- Uncovered services and extras. Include dental, vision, hearing, transportation or other benefits only after checking their eligibility rules, frequency limits, provider restrictions and dollar allowances. Also budget for services neither option covers.
A simple formula is:
Annual total = base Medicare premiums + plan premiums + expected medical cost sharing + prescription spending + access or uncovered-service costs − usable included benefits.
Keep “expected” and “worst reasonable” totals in separate columns. A low expected total does not eliminate the need to understand the high-use exposure.
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How should you model routine and high-use years?
Run at least two scenarios because the plans distribute risk differently.
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Routine-use scenario
Start with the care you can reasonably anticipate: regular office visits, preventive services, maintenance prescriptions, occasional tests and any recurring therapy. Use the exact copays or coinsurance shown in the Evidence of Coverage for the Advantage plan and the benefits listed for the Medigap letter. Add annual premiums even if no claim is filed. This scenario shows the cash cost of ordinary health maintenance.
High-use scenario
Add a hospitalization, frequent specialist visits, imaging, rehabilitation or other care that is plausible for your health history. For Medicare Advantage, apply the plan’s cost-sharing rules until you reach its annual limit for covered Medicare services. Check which services count toward that limit and whether separate drug rules apply. For Medigap, apply the policy’s specific coverage of Part A and Part B cost sharing, then add premiums and any uncovered services. Because Original Medicare has no general annual out-of-pocket limit, do not assume every high-cost service is capped.
Compare the gap between the two scenarios. A larger premium for Medigap may buy more predictable medical bills, while an Advantage plan may keep fixed monthly costs lower but expose you to more service-by-service charges. Neither pattern is automatically better; it depends on your cash-flow needs and ability to absorb a bad year.
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What does provider access change?
Provider access can outweigh a small premium difference. Original Medicare generally allows you to see any doctor or hospital that takes Medicare. Confirm participation and assignment before care, particularly when traveling or seeing a new specialist.
Medicare Advantage plans typically use a service area and network for non-emergency care. Depending on the plan, going out of network may cost more or may not be covered. Referrals and prior authorization can also apply. Before enrolling, check the current provider directory, the hospital’s participation, referral rules and authorization requirements for treatments you already use. Directories can change, so call the provider and the plan when a particular doctor or facility is essential.
For people who spend part of the year in another state, travel frequently or see specialists at several systems, estimate the financial and practical cost of network restrictions. Original Medicare’s broader provider access may be worth a higher recurring premium; for someone who receives nearly all care locally, a network plan may be less expensive.
How do prescription costs fit into the decision?
Most Medicare Advantage plans include Part D drug coverage, but the formulary, tiers, pharmacy network, deductible and cost sharing vary. Enter your actual medicines and preferred pharmacies into Medicare.gov’s comparison tool. A plan with a low medical premium can still produce a high annual drug total if a medication is on a costly tier or a preferred pharmacy is unavailable.
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With Original Medicare and Medigap, you generally enroll in a separate Part D plan. Medigap policies sold after 2005 do not include prescription coverage, so compare the Part D premium and projected drug spending alongside the Medigap premium. Keep medical and drug calculations separate because the Medicare Advantage medical out-of-pocket limit does not automatically cap Part D expenses.
For 2026, Medicare.gov lists $2,100 as the annual out-of-pocket limit for Part D prescription drug coverage. This is a drug-cost figure; it is not the Medicare Advantage limit for medical services and it is not a Medigap limit. Use the applicable Part D rules for the plan year you are evaluating.
Are extra benefits enough to make Medicare Advantage cheaper?
Some Medicare Advantage plans advertise dental, vision, hearing or other supplemental benefits. Treat them as conditional value, not cash discounts. Check the covered service, annual allowance, frequency limit, approved provider list, prior authorization and whether unused benefits expire. If you would not otherwise buy the service, do not subtract the full advertised allowance from your comparison.
Original Medicare and Medigap generally do not cover routine dental, routine vision, hearing aids or long-term care. Add realistic out-of-pocket budgets for those needs to the Medigap scenario. A Medigap policy can still be the better fit when broad medical access and predictable Part A and Part B cost sharing matter more than bundled extras.
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Medigap benefits are standardized by plan letter, but insurers can charge different prices for the same letter. Request current quotes for the same letter from multiple insurers in your location and record how each insurer prices the policy. Medicare.gov notes that premiums can vary by location, insurer and plan and commonly rise over time.
Compare the policy’s covered cost sharing with the services you actually expect. A lower premium may come with more exposure to specified deductibles or coinsurance, while a higher premium may cover more of those amounts. Confirm whether the quote is for the exact letter and effective date you need; otherwise the comparison is not like-for-like.
Remember that Medigap supplements Original Medicare. It cannot pay Medicare Advantage cost sharing, and you generally choose one route or the other rather than stacking both for the same coverage.
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Which option fits different retirement situations?
Use these profiles as starting points, then verify local plans and quotes.
A healthy retiree focused on the lowest monthly bill
A $0-premium Medicare Advantage plan may look attractive when you use little care and all preferred providers are in network. Calculate the annual total anyway: Part B remains due, and a single emergency, imaging episode or specialist series can create substantial cost sharing. Review the plan’s annual medical limit before choosing it for the premium alone.
A retiree with frequent or unpredictable care
Compare the high-use scenario first. Medigap’s premium may be worthwhile if its benefits cover much of the Part A and Part B cost sharing you are likely to incur and you value predictable bills. Medicare Advantage can still win if its annual limit and network meet your needs, but confirm every major provider and authorization rule.
A retiree who travels or sees out-of-area specialists
Original Medicare with Medigap generally offers the simpler provider-access rule: use providers that take Medicare. An Advantage plan may work if it has suitable travel or out-of-network provisions, but verify those terms in writing rather than assuming national access.
A retiree with expensive or unusual prescriptions
Compare the medication list before comparing medical premiums. Check formulary placement, quantity limits, prior authorization, preferred pharmacies and the separate Part D total. A plan’s extra benefits do not compensate for a drug coverage mismatch.
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Medicare Advantage usually combines medical and Part D coverage in one plan and may add supplemental benefits. That convenience has a trade-off: the plan controls networks and its own cost-sharing rules. Original Medicare plus Medigap and Part D uses separate policies but can provide broader provider choice.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How can you compare plans for your ZIP code?
Use Medicare.gov’s helpful tools and follow this sequence:
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- Enter your ZIP code and identify the Medicare Advantage, stand-alone Part D and Medigap options available where you live.
- Enter every prescription, dosage and preferred pharmacy. Save the estimated annual premium and drug total for each candidate.
- Open the plan details and record medical deductibles, visit copays, coinsurance, the annual medical out-of-pocket limit, network rules and prior-authorization requirements.
- Search for your doctors, hospitals, laboratories and therapists. Call essential providers to confirm participation because directories and contracts can change.
- For Original Medicare, choose a Medigap plan letter that meets your coverage needs and request current insurer quotes for that same letter. Add a separate Part D plan to the worksheet.
- Run routine-use and high-use scenarios. Include premiums in both, separate medical and drug limits, and budget for services that neither option covers.
- Recheck the comparison for the plan year you will actually use. Local availability, premiums, formularies and networks can change annually.
Medicare.gov provides plan comparisons and drug-cost estimates, while the insurer supplies the current Medigap quote. Keep screenshots or printed estimates with the date checked so you can explain how your decision was reached.
What mistakes make a “cheap” plan expensive?
- Calling a $0 premium free. The Part B premium continues, and medical and drug cost sharing still apply.
- Comparing monthly premiums only. Add the annual cost of visits, tests, hospital care, prescriptions and deductibles.
- Using the medical out-of-pocket limit as an all-purpose cap. It applies to covered Medicare services under the Advantage plan; premiums, noncovered care and separate drug rules remain.
- Assuming Medigap covers everything. Its benefits are limited to specified Original Medicare cost sharing, and routine dental, vision, hearing aids and long-term care generally remain outside the policy.
- Ignoring networks. A preferred doctor or hospital outside the network can change the economics and convenience of an Advantage plan.
- Using a generic drug list. One formulary change or pharmacy tier can alter annual spending materially.
- Comparing different Medigap letters. Get quotes for the same standardized letter before judging insurers’ prices.
- Assuming today’s price lasts forever. Recheck premiums, benefits, networks and formularies for each plan year.
What is the practical bottom line?
Choose Medicare Advantage when the local plan’s network, formulary and high-use limit fit your care and you value bundled coverage or a potentially lower recurring premium. Choose Original Medicare with Medigap when broad provider access and more predictable Part A and Part B cost sharing justify the Medigap and Part D premiums. If the two totals are close, let provider access, prescription reliability and your ability to handle a high-use year decide.
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Frequently Asked Questions
Can I have Medicare Advantage and Medigap at the same time?
No. Medigap is designed to supplement Original Medicare and generally cannot pay Medicare Advantage cost sharing. If you switch routes, verify the enrollment and policy timing before ending existing coverage.
Does Medigap cover prescription drugs?
Medigap policies sold after 2005 do not include drug coverage. People with Original Medicare and Medigap generally add a separate Part D plan and should compare that plan’s formulary, pharmacy network and annual drug cost.
Does the Medicare Advantage out-of-pocket maximum include premiums?
No. The annual limit applies to covered Medicare medical services under the plan, not the plan premium, Part B premium, noncovered care or every prescription expense. Check the plan’s Evidence of Coverage for exactly which charges count.
Why can two Medigap quotes for the same letter differ?
Benefits for a standardized Medigap letter are generally the same, but insurers set different premiums based on the policy, insurer and location. Request current quotes for the identical letter and effective date before comparing prices.
