Choosing between Original Medicare, Medigap, and Medicare Advantage is one of the biggest Medicare decisions you’ll make. Each option works differently in terms of costs, doctor access, coverage, and flexibility.
Quick Overview
| Feature | Original Medicare | Original Medicare + Medigap | Medicare Advantage (Part C) |
|---|---|---|---|
| Includes Part A & B | Yes | Yes | Yes |
| Prescription Drug Coverage | No (buy Part D separately) | No (buy Part D separately) | Usually included |
| Doctor Choice | Any doctor accepting Medicare | Any doctor accepting Medicare | Usually network-based |
| Referrals Needed | No | No | Often yes |
| Out-of-Pocket Maximum | No | Usually very low | Yes |
| Extra Benefits (Dental/Vision/Hearing) | Usually no | Usually no | Often included |
| Monthly Premiums | Lowest | Highest | Usually lower |
| Predictability of Costs | Low | High | Moderate |
| Prior Authorization | Rare | Rare | Common in many plans |
Original Medicare
Original Medicare is the federal government program that includes:
How it works
You can see almost any doctor or hospital in the U.S. that accepts Medicare.
People who:
Medigap (Medicare Supplement)
Medigap works with Original Medicare to help pay deductibles, copays, and coinsurance.
Common plans include:
How it works
You keep Original Medicare, then add:
People who:
Medicare Advantage (Part C)
Medicare Advantage is an alternative to Original Medicare offered by private insurance companies.
Most plans combine:
Many also include:
How it works
The insurance company manages your Medicare benefits.
Most plans are:
People who:
Biggest Difference: Flexibility vs Cost
Bottom Line
| If You Want… | Usually Best Choice |
|---|---|
| Lowest monthly premium | Medicare Advantage |
| Maximum doctor freedom | Original Medicare + Medigap |
| Predictable medical costs | Medigap |
| Extra benefits like dental | Medicare Advantage |
| Nationwide flexibility | Original Medicare + Medigap |
| Simplicity in one plan | Medicare Advantage |
