Medicare 101
Medicare Advantage vs.
Medicare Supplement:
what’s the difference?
Both come from private insurance companies. Both exist because Original Medicare leaves you exposed. They just solve it in opposite ways — and in practice you go down one road or the other.
Medicare 101
Medicare Advantage vs.
Medicare Supplement:
what’s the difference?
Both come from private insurance companies. Both exist because Original Medicare leaves you exposed. They just solve it in opposite ways — and in practice you go down one road or the other.
The Short Version
Original Medicare leaves gaps. Deductibles, coinsurance, and no annual cap on what you can spend. Both options below exist to deal with that.
Medicare Advantage hands your benefits to a private plan. Lower monthly cost, a network, and a yearly limit on what you pay for medical care.
A Medicare Supplement keeps Original Medicare and pays your share of it. Higher monthly cost, no network, and far fewer surprises.
Timing matters more than price. The door into a Supplement is widest at 65 and can close later. The door into Advantage stays open.
Section 1 of 2
Medicare Advantage (Part C)
A private plan that takes over the delivery of your Medicare benefits.
How it works
You stay enrolled in Medicare and keep paying your Part B premium, but a private insurance company administers your benefits and you use the plan’s ID card for day-to-day care. Most plans build in Part D prescription coverage, so it’s one plan and one card instead of several.
Why people choose it
A low monthly premium — many plans charge nothing beyond Part B
Medical and drug coverage bundled together
An annual cap on what you pay for covered Part A and Part B services
No health questions, at any time
Millions of people are enrolled in Medicare Advantage and are satisfied with it. If your doctors are in network and your health is steady, it can work well.
The trade-offs to understand first
You’re generally limited to the plan’s network of doctors and hospitals
Referrals may be required, and some care needs prior authorization before the plan will pay
Networks and cost-sharing can change each January
Coverage is generally tied to a service area, which matters if you travel or live in two places
Part D drug costs and premiums don’t count toward that annual cap
None of that makes it a bad choice. It makes it a choice with a shape — and the shape is worth knowing before you’re in it.
Section 2 of 2
Medicare Supplement (Medigap)
A separate policy that closes the holes Original Medicare leaves open.
Start with the holes
Original Medicare is good coverage with specific gaps. There’s a hospital deductible each benefit period. Part B generally pays 80% of covered services and leaves the other 20% to you — with no annual limit on that 20%. A long hospital stay, a cancer course, a serious surgery: the bill keeps going. That open-ended exposure is what a Supplement is built to close.
How it works
You keep Original Medicare exactly as it is and keep using any doctor or hospital in the country that accepts it — no network, no referrals, no prior authorization. The Supplement then pays the deductibles and coinsurance Medicare would otherwise leave to you. Because these policies are standardized by law, a given lettered plan covers the same things no matter which company sells it; what differs is price and service. (Massachusetts, Minnesota and Wisconsin standardize theirs differently.)
What it closes
The 20% with no ceiling. The biggest single exposure in Original Medicare.
The 20% with no ceiling. The biggest single exposure in Original Medicare.
The approval question. If Medicare covers it, the Supplement follows Medicare.
The January surprise. Standardized benefits don’t get restructured each year.
The travel gap. Coverage works anywhere in the country Medicare is accepted.
What it costs you
A monthly premium on top of Part B, and premiums generally increase over time
A separate Part D plan if you want prescription coverage — and you generally should, or a late enrollment penalty may follow you
No extra benefits bundled in. It does one job.
A policy covers one person. If you and your spouse both want one, you each buy your own.
Plans C and F are no longer available to people new to Medicare on or after January 1, 2020
You pay more every month in exchange for knowing the number. For a lot of people that trade is the whole point — especially anyone who expects to use their coverage.
Side By Side
The comparison
Feature
Medicare Advantage
Medicare Supplement
How it works
A private plan takes over the delivery of your Part A and Part B benefits.
You keep Original Medicare. The policy pays your share of what Medicare covers.
Doctors and hospitals
Generally limited to the plan’s network. Out-of-network care can cost more or may not be covered.
Any doctor or hospital in the country that accepts Original Medicare. No networks, apart from Medicare SELECT policies.
Referrals and approvals
Referrals are often required, and some care needs prior authorization.
No referrals. No prior authorization.
Prescription drugs
Usually built in
Not included — you add a separate Part D plan.
What you pay monthly
Your Part B premium ($202.90 standard in 2026). Many plans add little or no premium of their own.
Your Part B premium, plus the policy premium, plus a Part D plan. Premiums generally rise over time.
What you pay when you get care
Copays and coinsurance as you use services, up to the plan’s annual limit for Part A and Part B services.
Little to nothing at the point of care, depending on which standardized plan you choose.
Traveling or living elsewhere part of the year
Copays and coinsurance as you use services, up to the plan’s annual limit for Part A and Part B services.
Little to nothing at the point of care, depending on which standardized plan you choose.
Year-to-year changes
Benefits, networks and cost-sharing can change each January.
Benefits are standardized and don’t get reshuffled annually.
Health questions
None at any time.
None during your six-month Medigap open enrollment window. After it, most states let insurers ask — and decline.
This describes how these two types of coverage generally work — it is not a description of any specific plan. Availability, benefits and
costs vary by company and county and change each year. Medicare.gov and your State Health Insurance Assistance Program are
useful independent references.
Side By Side
The comparison
Feature
Medicare Advantage
Medicare Supplement
How it works
Medicare Advantage
A private plan takes over the delivery of your Part A and Part B benefits.
Medicare Suplement
You keep Original Medicare. The policy pays your share of what Medicare covers.
Doctors and hospitals
Medicare Advantage
Generally limited to the plan’s network. Out-of-network care can cost more or may not be covered.
Medicare Suplement
Any doctor or hospital in the country that accepts Original Medicare. No networks, apart from Medicare SELECT policies.
Referrals and approvals
Medicare Advantage
Referrals are often required, and some care needs prior authorization.
Medicare Suplement
No referrals. No prior authorization.
Prescription drugs
Medicare Advantage
Usually built in
Medicare Suplement
Not included — you add a separate Part D plan.
What you pay monthly
Medicare Advantage
Your Part B premium ($202.90 standard in 2026). Many plans add little or no premium of their own.
Medicare Suplement
Your Part B premium, plus the policy premium, plus a Part D plan. Premiums generally rise over time.
What you pay when you get care
Medicare Advantage
Copays and coinsurance as you use services, up to the plan’s annual limit for Part A and Part B services.
Medicare Suplement
Little to nothing at the point of care, depending on which standardized plan you choose.
Traveling or living elsewhere part of the year
Medicare Advantage
Copays and coinsurance as you use services, up to the plan’s annual limit for Part A and Part B services.
Medicare Suplement
Little to nothing at the point of care, depending on which standardized plan you choose.
Year-to-year changes
Medicare Advantage
Benefits, networks and cost-sharing can change each January.
Medicare Suplement
Benefits are standardized and don’t get reshuffled annually.
Health questions
Medicare Advantage
None at any time.
Medicare Suplement
None during your six-month Medigap open enrollment window. After it, most states let insurers ask — and decline.
This describes how these two types of coverage generally work — it is not a description of any specific plan. Availability, benefits and costs vary by company and county and change each year. Medicare.gov and your State Health Insurance Assistance Program are useful independent references.
The Thing To Get Right
Timing beats price
You can move from a Supplement to Medicare Advantage fairly easily — during the Medicare Open Enrollment Period, October 15 to December 7 each year, with coverage starting January 1. There are no health questions to join an Advantage plan.
Going the other direction is harder. You can leave an Advantage plan and return to Original Medicare during that same window, or between January 1 and March 31. The catch is the Supplement itself: unless you’re inside your one-time Medigap open enrollment period or you qualify for a guaranteed-issue right, most states allow the insurance company to ask health questions — and to decline you or charge you more.
The sentence to remember
Your Medigap open enrollment period is six months, and it starts the month you’re 65 or older and enrolled in Part B. During it you can’t be turned down or charged more for your health. Miss it and, in most states, someone else decides whether the door opens for you. A few states offer broader rights, so where you live matters.
Common Questions
What people ask us
Can I have Medicare Advantage and a Supplement at the same time?
In practice you choose one. It’s illegal for anyone to sell you a Supplement while they know you’re enrolled in an Advantage plan, unless you’re switching back to Original Medicare. If you already own a Supplement you have the right to keep it, but it can’t pay an Advantage plan’s deductibles, copays or coinsurance.
Do I still pay the Part B premium either way?
Yes. Whichever path you take, you keep paying Part B — $202.90 for most people in 2026, more for some based on income.
Does a Supplement cover prescriptions?
No. Supplements sold today don’t include drug coverage, so you’d generally add a separate Part D plan. Skipping drug coverage entirely can mean a late enrollment penalty later.
What if I get Medicare before 65 through disability?
Then you generally don’t get a federally guaranteed Medigap window until you turn 65. Some states provide one anyway. This is one of the situations where the state you live in changes the answer completely.
I’m a veteran with VA or TRICARE. Does this change?
It can change the math considerably. VA health care, TRICARE For Life and CHAMPVA each work with Medicare differently, and the right answer for a veteran often looks nothing like the right answer for someone without those benefits.
two minutes
Which one actually fits you?
Your doctors, your prescriptions, your travel, your state.
Answer a few questions and see where you land — before anyone tries
to sell you anything.
Takes 2 minutes
No pressure
No obligation
two minutes
Which one actually fits you?
Your doctors, your prescriptions, your travel, your state.
Answer a few questions and see where you land — before anyone tries
to sell you anything.
Takes 2 minutes
No pressure
No obligation
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