Side-by-side comparison
| Original Medicare (+ Medigap + Part D) | Medicare Advantage | |
|---|---|---|
| Choice of doctors | Any provider nationwide that accepts Medicare | Usually a network; PPOs allow out-of-network at higher cost |
| Monthly premiums | Part B + Medigap + Part D | Part B + plan premium (often $0) |
| Out-of-pocket limit | None without Medigap; Medigap covers most gaps | Yes: up to $9,250 in-network in 2026 |
| Prescription drugs | Separate Part D plan | Usually included |
| Dental, vision, hearing | Routine care not covered | Most plans include some |
| Prior authorization | Rarely required | Required for some services in almost all plans |
| Travel | Covered anywhere in the U.S.; some Medigap plans cover foreign emergencies | Often limited outside the service area except emergencies |
Sources: Medicare.gov; KFF (June 2026).
Medicare Advantage: pros and cons
About 35.2 million people, 55% of those eligible, chose Medicare Advantage in 2026. Its appeal is clear: 75% of people in individual plans with drug cover paid no premium beyond Part B, almost all plans offer eye exams or glasses (over 99%), dental (98%) and hearing benefits (95%), and every plan has an annual in-network spending limit.
The trade-offs: you’re usually limited to a network, 99% of enrollees are in plans that require prior authorization for some services, and copays can add up quickly if you’re seriously ill. Plans also change every year. For 2027, about 3.2 million people’s plans are ending, the average in-network limit is expected to rise 9% to $6,603, and KFF estimates 638,000 people will have no Medicare Advantage plan available in their county.
Original Medicare: pros and cons
Original Medicare lets you see any doctor or hospital in the country that accepts Medicare, usually without referrals or prior approval. On its own, though, it has no out-of-pocket cap and leaves you paying 20% of most outpatient costs. Most people add a Medigap policy, which can cover nearly all of that, plus a Part D drug plan. Monthly premiums are higher, but costs are predictable.
The switching trap
You can switch from Original Medicare to Medicare Advantage during any open enrollment. Going back is harder. Outside your first six-month Medigap Open Enrollment Period, Medigap insurers in most states can use medical underwriting to charge more or refuse you. There are limited “trial rights”: if you join Medicare Advantage when you first get Medicare at 65, or drop Medigap to try Medicare Advantage for the first time, you can usually return to Medigap with guaranteed issue within 12 months. Think carefully before leaving Medigap.
Who each option suits
| Medicare Advantage may suit you if… | Original Medicare + Medigap may suit you if… |
|---|---|
| You’re healthy and want low premiums | You have chronic conditions or expect significant care |
| Your doctors are in the plan’s network | You want to keep doctors or use specialist centers anywhere |
| You value dental, vision and hearing extras | You travel or live in more than one state |
| You’re comfortable with prior authorization | You want predictable costs and can afford higher premiums |
For plan-level comparisons, see our guide to choosing the best Medicare plans and the open enrollment checklist. For costs, see Medicare costs.
Frequently asked questions
Is Medicare Advantage cheaper than Original Medicare?
Premiums are usually lower, often $0 beyond Part B, but out-of-pocket costs can be higher if you need a lot of care, up to the plan’s annual limit.
Can I switch from Medicare Advantage back to Original Medicare?
Yes, during open enrollment (Oct 15–Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1–Mar 31). Getting a Medigap policy may be harder because of medical underwriting.
Can I have Medigap and Medicare Advantage?
No. Medigap can’t pay Medicare Advantage costs, and insurers can’t sell you Medigap while you’re in Medicare Advantage unless you’re switching back.
Does Medicare Advantage cover care when traveling?
Emergency and urgent care are covered nationwide, but routine care outside the plan’s area may not be.
Why is my Medicare Advantage plan ending?
Insurers decide each year which plans to offer. About 3.2 million people’s individual plans are ending for 2027, so they need to choose new cover during open enrollment.
Sources
- KFF – Medicare Advantage in 2026
- KFF – Medicare Advantage fact sheet
- CMS – Medicare Advantage and Part D expected to remain stable in 2027 (Sept 2026)
- Straight Arrow News – Medicare open enrollment begins with fewer plans (Oct 2026)
- Medicare.gov – Medigap and Medicare Advantage
- Medicare.gov – Medigap guaranteed issue rights
- Medicare.gov – Medicare costs
- Medicare.gov – Dental services
Insurance prices, discounts and rules change often and vary by state. Figures were checked in October 2026; confirm details with the insurer or your state insurance department.