Medicare Advantage vs. Medicare Supplement: A Complete Side-by-Side Comparison

When you become eligible for Medicare, you face an important choice. You can stay with Original Medicare and add a Medicare Supplement plan. Or you can switch to a Medicare Advantage plan.

These two options work very differently. This article explains how Medicare Advantage and Medicare Supplement plans compare. We will cover costs, coverage, networks, and help you understand which option may work better for your situation.

What Is Medicare Advantage?

Medicare Advantage is also called Medicare Part C. It is an alternative way to receive your Medicare benefits. Private insurance companies offer Medicare Advantage plans.

When you enroll in Medicare Advantage, you leave Original Medicare. The Medicare Advantage plan replaces Parts A and B. It must cover everything Original Medicare covers, but it can do so with different rules and costs.

Most Medicare Advantage plans include prescription drug coverage. Many also offer extra benefits like dental, vision, hearing, and fitness programs.

What Is Medicare Supplement Insurance?

Medicare Supplement insurance is also called Medigap. These are private insurance policies that work alongside Original Medicare.

You keep Original Medicare Parts A and B. The Medigap policy helps pay for out-of-pocket costs like deductibles, coinsurance, and copayments.

Medigap plans do not include prescription drug coverage. If you have a Medigap plan and need drug coverage, you must enroll in a separate Medicare Part D plan.

Key Differences Between Medicare Advantage and Medicare Supplement

How They Work with Original Medicare

Medicare Advantage replaces Original Medicare. When you enroll, Medicare pays the insurance company to manage your care. You receive all your Part A and Part B benefits through the private plan.

Medicare Supplement works alongside Original Medicare. You keep Parts A and B. The Medigap policy pays some or all of the costs that Original Medicare does not cover.

Network Restrictions

Most Medicare Advantage plans have provider networks. You typically must use doctors and hospitals in the plan network to get the lowest costs. Some plans only cover out-of-network care in emergencies.

Medicare Supplement plans have no networks. You can see any doctor or hospital that accepts Medicare anywhere in the United States. You do not need referrals to see specialists.

Prescription Drug Coverage

Most Medicare Advantage plans include Part D prescription drug coverage. This is bundled into the plan. You cannot have a separate Part D plan if you have Medicare Advantage.

Medicare Supplement plans do not include drug coverage. You need to enroll in a standalone Medicare Part D plan if you want prescription coverage.

Extra Benefits

Medicare Advantage plans often include extra benefits not covered by Original Medicare. These may include dental, vision, hearing, fitness memberships, and transportation to medical appointments.

Medicare Supplement plans do not include extra benefits. They only help pay for costs related to Medicare-covered services.

Cost Comparison

Monthly Premiums

Medicare Advantage plans often have low monthly premiums. Many plans have zero premium beyond the Part B premium you already pay. However, you still pay the monthly Part B premium to Medicare.

Medicare Supplement plans have higher monthly premiums. You pay the Part B premium plus the Medigap premium. Depending on the plan and your location, Medigap premiums can range from $100 to $400 or more per month.

Out-of-Pocket Costs When You Use Healthcare

Medicare Advantage plans charge copays and coinsurance when you receive care. For example, you might pay $20 for a doctor visit, $50 for a specialist, or $300 per day for a hospital stay.

These costs vary by plan and service. If you need frequent medical care, the copays can add up quickly.

Medicare Supplement plans provide more predictable costs. With comprehensive plans like Plan G, you typically only pay the Part B deductible each year. After that, you have little to no out-of-pocket costs for Medicare-covered services.

Out-of-Pocket Maximum

Medicare Advantage plans have an annual out-of-pocket maximum. Once you reach this limit, the plan pays 100 percent of covered services for the rest of the year. This limit is set by law and cannot exceed $8,850 in 2026.

Original Medicare with a Medicare Supplement plan does not have an out-of-pocket maximum. However, with comprehensive Medigap plans, your out-of-pocket costs are already very low or zero after deductibles.

Which Costs More Overall?

The answer depends on how much healthcare you use. If you are healthy and rarely see doctors, Medicare Advantage may cost less due to low or zero premiums.

If you have ongoing health issues or expect to use healthcare frequently, Medicare Supplement may be more cost-effective. The higher premiums are offset by lower out-of-pocket costs when you need care.

Coverage Details

What Medicare Advantage Covers

Medicare Advantage plans must cover all services that Original Medicare covers. This includes hospital stays, doctor visits, preventive care, and medical equipment.

Plans can add additional benefits. Many include dental, vision, hearing, and wellness programs. Some offer transportation, over-the-counter allowances, and meal delivery after hospital stays.

What Medicare Supplement Covers

Medicare Supplement plans help pay for Medicare cost-sharing. Depending on the plan, this can include:

• Part A deductible
• Part B deductible
• Part A coinsurance
• Part B coinsurance or copayment
• Skilled nursing facility coinsurance
• Part B excess charges
• Foreign travel emergency care

The most comprehensive plans, like Plan G, cover nearly all of these costs.

When Medicare Advantage Makes Sense

Medicare Advantage can be a good choice in certain situations:

• You want low monthly premiums and are willing to pay copays when you use care
• You stay in one area and are comfortable using network providers
• You value extra benefits like dental, vision, and fitness programs
• You want prescription drug coverage included in one plan
• You prefer the protection of an out-of-pocket maximum

When Medicare Supplement Makes Sense

Medicare Supplement may be better if:

• You want to see any Medicare provider without network restrictions
• You travel frequently or spend time in multiple states
• You prefer predictable costs and are willing to pay higher premiums
• You have ongoing health issues and use healthcare frequently
• You want to keep Original Medicare and have full coverage flexibility

Enrollment Considerations

Medical Underwriting

Medicare Advantage plans do not require medical underwriting. You cannot be turned down due to health conditions.

Medicare Supplement plans often do require medical underwriting, except during certain guaranteed issue periods. The best time to enroll is during your Medigap Open Enrollment Period, which starts when you turn 65 and enroll in Part B.

When You Can Enroll or Switch

You can enroll in Medicare Advantage during the Annual Enrollment Period, which runs from October 15 to December 7 each year. There is also a Medicare Advantage Open Enrollment Period from January 1 to March 31.

Medicare Supplement plans can be purchased at any time if you pass medical underwriting. However, you have guaranteed issue rights during specific enrollment periods when you cannot be turned down.

Important Rule: You Cannot Have Both

It is illegal for insurance companies to sell you a Medicare Supplement policy if you are enrolled in Medicare Advantage. You must choose one or the other.

If you have a Medigap policy and enroll in Medicare Advantage, your Medigap coverage will end. If you later decide to return to Original Medicare, you may need to answer health questions to get a new Medigap policy.

Switching Between Medicare Advantage and Medicare Supplement

You can switch between Medicare Advantage and Medicare Supplement, but timing and health status matter.

Switching from Medicare Supplement to Medicare Advantage is usually easier. You can do this during the Annual Enrollment Period without medical underwriting.

Switching from Medicare Advantage to Medicare Supplement is more difficult. You may need to answer health questions unless you qualify for a guaranteed issue right. This is one reason to carefully consider your initial choice.

Questions to Ask Yourself

When deciding between Medicare Advantage and Medicare Supplement, consider these questions:

• Do you want to see any doctor, or are you comfortable with network restrictions?
• Do you prefer low monthly costs or predictable expenses?
• How often do you expect to use healthcare services?
• Do you travel frequently or live in multiple locations?
• Are extra benefits like dental and vision important to you?
• Do you want drug coverage bundled with your plan or separate?

Final Thoughts

There is no universally better choice between Medicare Advantage and Medicare Supplement. The right option depends on your individual needs, health status, budget, and preferences.

Medicare Advantage offers lower premiums and extra benefits but comes with network restrictions and variable costs. Medicare Supplement provides freedom to see any provider and predictable expenses but has higher monthly premiums.

Take time to compare your options carefully. Consider both immediate costs and long-term needs. Remember that switching later may be more difficult, especially if you develop health issues.