Medicare Supplement vs. Medicare Advantage: What’s the Difference?
After enrolling in Original Medicare (Parts A and B), the next step is deciding how you want to cover the remaining out-of-pocket costs (original Medicare generally covers about 80%). At this point, Medicare beneficiaries typically choose between two distinct paths:
- Enrolling in a Medicare Advantage (Part C) plan, or
- Keeping Original Medicare and adding a Medicare Supplement (Medigap) plan along with a standalone Part D Prescription Drug Plan (PDP).
Both approaches cover the gaps — but they work very differently.
1. Medicare Advantage
Medicare Advantage plans are offered by private insurance companies and replace Original Medicare as your primary coverage.
Most MAPD Plans:
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Include medical + prescription coverage
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Operate with provider networks (HMO v PPO)
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Have lower monthly premiums
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Require copays + coinsurance for medical care
Best Suited for individuals who:
Do not frequently visit doctors
Are comfortable using provider networks
Want bundled coverage in one plan
Prefer lower monthly premiums
2. Medicare Supplement (Medigap) + Part D*
Medicare Supplement plans work with Original Medicare and help cover leftover out-of-pocket costs from Parts A and B.
*Because Medigap does not include drug coverage, a separate Part D plan is required*
Most Medigap Plans:
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Work with any doctor who accepts Medicare
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Have NO network restrictions
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Have higher monthly premiums
- Offer predictable out-of-pocket expenses
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DO NOT include coverage for medications
Best Suited for individuals who:
Visit their Doctors Often (more than 1x per year)
Want broad access to many doctors
Travel Often
Prefer predictable costs over lower premiums
Take medications with high monthly costs
Medicare Advantage vs. Medigap: Key Differences
| Feature | Medicare Advantage (Part C) | Medigap (Medicare Supplement) |
|---|---|---|
| Coverage Type | Combines hospital (Part A), medical (Part B), and usually drug coverage (Part D) into one plan | Works alongside Original Medicare to help cover out-of-pocket medical costs |
| Provider Network | Limited to the plan’s provider network (HMO or PPO) | No network restrictions — see any provider nationwide who accepts Medicare |
| Monthly Premiums | Often lower premiums, but greater copays and coinsurance when care is used | Higher premiums, but typically lower, predictable out-of-pocket expenses. |
| Out-of-Pocket Maximum | Yes — includes an annual maximum that limits total medical spending | No maximum under Original Medicare (though many services are covered by Medigap) |
| Extra Benefits | Often includes some level of dental, vision, hearing, fitness, OTC benefits, etc. | Rarely include extra benefits — focuses only on medical cost coverage |
| Prescription Drugs | Drug coverage is bundled; already built into MAPD plan options |
Requires separate Part D Prescription Drug Plan for an additional monthly premium
|
| Travel Coverage | Generally limited outside the plan’s service area | Nationwide provider access; some plans include limited foreign travel emergency coverage |