Medicare Advantage or Medicare Supplement? How to Choose in 2026
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Information sourced as of October 2025. The plan structures and typical costs below were current when this guide was published and match our companion PDF. The 2026 Part B figures below were the published projections at the time of writing. Premiums and deductibles are set annually and final amounts can differ, so confirm the current figures and your own plan’s costs at medicare.gov before deciding.
The choice in one sentence
Medicare Advantage means low or no monthly premium and you pay when you use care. Medicare Supplement means a higher monthly premium and you pay little or nothing when you use care.
Which is cheaper depends almost entirely on how much healthcare you actually use, and how much you value being able to see any doctor anywhere.
You cannot have both. Medigap only works alongside Original Medicare, so choosing Advantage rules it out.
What each one actually is
Medicare Supplement, also called Medigap
Medigap works alongside Original Medicare, filling the gaps it leaves. It covers the copays, coinsurance and deductibles Original Medicare does not pay. You keep Original Medicare as your primary coverage, and you buy a separate Part D plan for prescriptions.
You pay your Part B premium to Medicare, $206.50 in 2026, plus a monthly premium for the Medigap policy. When you get care, Original Medicare pays first and your Medigap policy covers most or all of what remains.
Medicare Advantage, also called Part C
Medicare Advantage replaces Original Medicare with a private insurer’s all in one plan. It bundles Part A hospital cover, Part B medical cover, usually Part D prescriptions, and often extras such as dental, vision, hearing and gym memberships.
You still pay your monthly Part B premium to Medicare, $206.50 in 2026, but the plan becomes your primary coverage. You use its network of doctors and hospitals, and you pay a copay each time you receive care.
Side by side
| Feature | Medicare Advantage | Medicare Supplement |
|---|---|---|
| Replaces or supplements? | Replaces Original Medicare | Supplements Original Medicare |
| Typical monthly premium | $0 to $50 | $100 to $300 |
| When you use care | Copay at each visit | Little or nothing |
| Doctor choice | Must use the network | Any doctor accepting Medicare |
| Prescription drugs | Usually included | Separate Part D plan required |
| Dental, vision, hearing | Often included | Not included |
| Out of pocket maximum | Yes, $9,250 in network for 2026 | No formal maximum, but predictable |
| Travel coverage | Limited to the plan’s service area | Nationwide |
| Specialist referrals | May be required with an HMO | Not required |
The two scenarios that make the maths obvious
These are illustrations using typical figures, not quotes. Your own numbers will differ.
Robert, a low user
Healthy, 66, two doctor visits a year, no chronic conditions.
On Medicare Advantage he pays a $0 plan premium and roughly $800 a year in copays, so about $800. On a Medigap Plan G at $200 a month he pays $2,400 in premiums plus the $288 Part B deductible, so roughly $2,688.
Medicare Advantage saves Robert about $1,888 a year.
Linda, a high user
68, diabetic, sees three specialists regularly, eight doctor visits a year.
On Medicare Advantage her $0 premium comes with roughly $4,000 a year in copays, so about $4,000. On the same Plan G her cost is unchanged at roughly $2,688, because Medigap costs the same whether she visits once or fifty times.
Medicare Supplement saves Linda about $1,312 a year, and that gap widens the sicker she gets.
This is the heart of the decision. Advantage is cheaper while you are well. Supplement is cheaper when you are not, and it is the year you become a high user that you cannot predict.
Networks, and the three ways they bite
Medicare Advantage plans come in two main shapes. An HMO requires in network doctors except in emergencies, requires referrals to see specialists, and carries the lowest premiums with the least flexibility. A PPO lets you go out of network at higher cost, needs no referrals, costs more than an HMO, and in 2026 carries a combined in and out of network maximum of $13,900.
Three situations catch people out repeatedly:
- The snowbird problem. If you split the year between two states, an HMO network may only cover care at home. Routine care in your winter state can be out of network entirely.
- The specialist problem. Develop a rare condition and the specialist you need may not be in your network. You either accept an in network alternative or pay full cost.
- The doctor departure problem. Your longtime physician can leave the network at any time, and then you either change doctor or pay considerably more.
With Medigap none of these apply. You can see any doctor who accepts Medicare, any specialist without a referral, at any hospital in the United States, including in your winter state and at major medical centres.
Out of pocket protection, compared
Medicare Advantage has a hard cap. Once you spend $9,250 on covered in network services in 2026, the plan pays 100% for the rest of the year. With a PPO going out of network, that ceiling can reach $13,900.
What counts toward it: doctor visit copays, hospital stay copays, outpatient procedures and durable medical equipment. What does not: your monthly premium, prescription drug costs, and anything your plan does not cover.
Medigap has no formal cap, but it does not need one, because your costs are known in advance. With Plan G you pay your premiums plus the $288 Part B deductible and essentially nothing at the point of care. With Plan N you pay less each month but add copays of up to $20 per office visit and up to $50 per emergency visit.
New for 2026, prescriptions are capped either way. Every Part D plan caps your out of pocket prescription costs at $2,100 a year and tracks it automatically. Once you reach it you pay nothing more for medications that year. This protects Medicare Advantage and Medicare Supplement users alike.
Our Medigap guide compares every plan letter side by side.
How to work out your own answer
- For Medicare Advantage: plan premium times 12, plus expected doctor visits times the copay, plus expected specialist visits times that copay, plus expected prescription costs.
- For Medicare Supplement: plan premium times 12, plus the Part B deductible of $288, plus a Part D plan premium times 12, plus expected prescription costs up to the $2,100 Part D cap.
- Then ask the questions money does not answer. Do you travel or live in two states? Do you have doctors you refuse to give up? Do you have a condition likely to need specialists? Are you comfortable with referrals and prior authorisation?
One timing point that matters more than the maths. Medigap gives you a single six month window with guaranteed acceptance, starting when you are 65 and enrolled in Part B. Choose Advantage now and decide to switch later, and insurers can screen your health, charge more, or decline you. The door does not stay open.
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Frequently asked questions
Can I have both Medicare Advantage and Medigap?
No. Medigap only works alongside Original Medicare. Enrolling in Medicare Advantage means a Medigap policy cannot pay anything.
Which is cheaper?
Medicare Advantage if you use little healthcare, Medicare Supplement if you use a lot. The crossover is roughly where annual copays exceed the Medigap premium.
Do I still pay the Part B premium with Medicare Advantage?
Yes. You pay it either way. The Advantage plan premium, often $0, sits on top of it.
Can I switch from Advantage to Medigap later?
You can try, but outside your one time six month Medigap window insurers can medically underwrite, charge more, or refuse you. This is the biggest hidden risk in choosing Advantage first.
Does Medicare Advantage cover me when travelling?
Generally only within the plan’s service area, apart from emergencies. Medigap works with any provider accepting Medicare anywhere in the United States.
Do I need a separate drug plan?
With Medigap, yes, a standalone Part D plan. Most Medicare Advantage plans include drug coverage already.
What is the out of pocket maximum?
Medicare Advantage caps in network spending at $9,250 in 2026, or up to $13,900 combined if you use out of network providers on a PPO. Medigap has no formal cap but very predictable costs.
Official resources
- Compare plans in your area: medicare.gov/plan-compare
- Medicare by phone: 1-800-633-4227, TTY 1-877-486-2048, 24 hours a day
- Free independent counselling from your State Health Insurance Assistance Program: shiphelp.org. They do not sell insurance
Details as of October 2025. Premiums, deductibles and plan availability change every year, so verify at medicare.gov before enrolling. GovClarity is not a government agency and does not sell insurance.
