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The Main Differences Between Medigap and Medicare Advantage Plans

Medicare Advantage and Medigap are two great ways that a Medicare beneficiary can offset out-of-pocket costs. One policy is more expensive than the other and includes extra benefits. The other is less expensive but has more restrictions.

Medicare Advantage

More than 17 million enrollees are estimated to have signed up for Medicare Advantage plans.

  • Medicare Advantage has lower premiums but comes with copays.
  • Medicare Advantage has a cap on out-of-pocket expenses.
  • Medicare Advantage HMOs, you can visit only providers in your plan. With Medicare Advantage PPOs, you can visit any provider with higher costs for out-of-network providers.
  • You may need referrals for specialists.
  • Annual Open Enrollment period.
  • Many Medicare Advantage plans include Part D.
  • There is no coverage if you are traveling outside of the United States.


Between December 2015 and December 2016, the national Medigap enrollment increased from 12.3 million to 13.1 million beneficiaries.

  • Medigap has higher premiums but no copays.
  • Medigap has low to no out-of-pocket costs.
  • Ability to choose any doctor or hospital that participates in the Medicare program.
  • No referrals are necessary.
  • Enroll when you sign up for Medicare at age 65.
  • Need to sign up for Part D drug coverage separately
  • Coverage outside of the United States is possible.

To enroll in Medicare, or to learn which Medicare Advantage or Medigap plan is the best for you, contact the professionals at at 844-374-1950.