Original Medicare vs. Medicare Advantage: A Side-by-Side Guide
When you are eligible for Medicare, there are two main ways to get your health coverage: Original Medicare (which you can pair with a Medicare Supplement, also called Medigap) or a Medicare Advantage plan. This guide gives you a simple side-by-side look so you can compare.
The key difference: Medigap works alongside Original Medicare and helps pay some of the costs Original Medicare leaves behind. Medicare Advantage (Part C) is a different way to get your Part A and Part B benefits, through a private company approved by Medicare.
1. Coverage and cost comparison
Feature | Original Medicare + Medigap | Medicare Advantage (Part C) |
How it works | Original Medicare pays first. Medigap helps pay eligible costs that are left. | A private, Medicare-approved company provides your Part A and Part B benefits. |
Doctors and hospitals | Any doctor or hospital in the U.S. that accepts Medicare. | Plans may use a network (HMO or PPO). Out-of-network coverage depends on the plan. |
Specialists | In most cases, no referral is needed. | A referral may be needed, depending on the plan. |
Prescription drugs | You can join a separate Medicare drug plan (Part D). | Most plans include drug coverage. |
Dental, vision and hearing | Routine care generally is not covered. | Many plans offer some extra benefits. Benefits vary by plan. |
Prior authorization | Generally not required for Original Medicare services. | May be required for some services. |
Monthly premium | Part B premium + Medigap premium (+ Part D premium if you join a drug plan). | Part B premium + plan premium, if any. Some plans have a $0 plan premium, but you must keep paying your Part B premium. |
Deductibles and copays | Depend on the Medigap plan letter you choose. | Copays or coinsurance vary by plan and service. |
Yearly out-of-pocket limit | Original Medicare has no yearly limit. Medigap helps pay eligible costs. | Each plan has a yearly limit on what you pay for covered Part A and Part B services. |
Travel | Coverage anywhere in the U.S. Some Medigap plans help with emergency care outside the U.S. | Plans generally cover emergency and urgent care anywhere in the U.S. Other care may need to be in the plan's area. |
2. Standardized Medigap plans (A to N)
In most states, every Medigap policy with the same letter offers the same basic benefits, no matter which company sells it. Premiums vary by company. Percentages show how much of each cost the Medigap plan pays.
*Plans F and G also have a high-deductible version in some states. **Plans K and L have a yearly out-of-pocket limit (the chart shows 2026 amounts); after you reach it, the plan pays 100% of covered services for the rest of the year. ***Plan N pays 100% of Part B coinsurance, except for a copay of up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission. Plans C and F are not available to people who became eligible for Medicare on or after January 1, 2020. Massachusetts, Minnesota and Wisconsin standardize Medigap plans differently.
3. Official Medicare resources
Original Medicare and Medigap
Medicare Advantage
Current Medicare premiums and deductibles: see this year's amounts on Medicare.gov
Not sure which path fits you?
The right choice depends on your doctors, prescriptions, health needs, travel and budget. Your rights to buy a Medigap policy, and whether health questions apply, can depend on when and where you apply. A licensed WellPlus agent can walk you through your options at no cost to you.
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We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Not connected with or endorsed by the U.S. government or the federal Medicare program.
This article is for general information only and is not a complete description of benefits. Plan availability, premiums, benefits and enrollment rights vary by plan, carrier, county and state. For complete details, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.
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