The big comparison
| Original Medicare + Medigap + Part D | Medicare Advantage (Part C) | |
|---|---|---|
| Who runs it | Federal government pays claims; Medigap and Part D sold by private companies | Private company approved by Medicare |
| Doctor & hospital choice | Any provider nationwide that accepts Medicare | Usually a network (HMO/PPO); rules vary |
| Specialist referrals | Generally not required | Sometimes required (often in HMOs) |
| Monthly premiums | Part B + Medigap + Part D premiums | Part B + plan premium (can be $0) |
| Out-of-pocket limit | None in Original Medicare alone; Medigap can cover most cost-sharing | Yes — yearly maximum for covered A/B services |
| Prescription drugs | Add a stand-alone Part D plan | Usually included |
| Dental, vision, hearing | Generally not covered | Often included; varies by plan |
| Prior authorization | Rarely required | May be required for some services |
| Travel within the U.S. | Coverage nationwide | Generally limited to emergencies/urgent care outside the network area |
| Changing later | Switching Medigap later may require health questions | Can change during annual enrollment windows |
Original Medicare might suit you if…
- You want to see any doctor or specialist who accepts Medicare, without referrals.
- You travel or split the year between states.
- You prefer predictable costs and are comfortable paying a higher monthly premium for Medigap.
Medicare Advantage might suit you if…
- Your doctors are in a plan's network.
- You want an all-in-one plan with drug coverage and possibly extra benefits.
- You'd rather pay lower monthly premiums and copays as you use care, with an annual out-of-pocket maximum.
Questions to ask before you choose
- Are my doctors, specialists and hospitals covered?
- Are all my prescriptions on the formulary — at what tier and with what restrictions?
- What would my total yearly cost be in a healthy year? In a bad year?
- Do I need coverage when traveling?
- Which extra benefits would I actually use?
- What are the plan's star ratings from Medicare?
Let us run the numbers
Share your ZIP code, doctors and prescriptions, and a licensed agent will compare the plans we offer side by side — at no cost to you.