Medigap Vs Medicare Advantage
Medigap and Medicare Advantage are opposite answers to the same question: supplement Original Medicare (Medigap) or replace it (MA). Premium, network freedom, and out-of-pocket structure all flip between them.
| Dimension | Medigap | Medicare Advantage |
|---|---|---|
| Relationship to Original Medicare | Supplements it | Replaces it |
| Monthly premium | $100–200 typical | $0–150 typical |
| Networks | None — any Medicare provider | HMO/PPO networks |
| Out-of-pocket ceiling | Near zero (G/N) | Annual MOOP ~$3,500–8,000 |
| Drug coverage | Separate Part D | Often built in |
| Travel/portability | Nationwide | Service-area bound |
The real trade-off
MA buys lower fixed costs and adds perks at the price of networks and utilization management; Medigap buys unlimited provider access and near-zero cost-sharing at a higher fixed premium. The 65-year-old decision point is explained with the OEP mechanics — and the MA trial right makes the first choice reversible once.
The switching asymmetry
MA-to-Medigap later can require underwriting (health can block it); Medigap-to-MA is guaranteed every October. Asymmetric in MA’s favor — which is why starting with Medigap while healthy is the conservative path. State-level wrinkles: state rules board.
FAQ
Can I have both Medigap and Medicare Advantage?
No — federal law prohibits selling Medigap to MA members (except narrow legacy cases).
Which is cheaper overall?
Healthy years: MA. High-utilization years: Medigap. The trial right (see file) hedges the first year.
Related reading: FAQ library · Trial right · Plans board