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The biggest decision
These two work very differently. Understanding the difference is most of the work. Neither one is better in general. They simply suit different people.
Two approaches
Approach one
Part A and Part B from Medicare, with a Medigap policy from a private company helping pay some costs Medicare doesn't.
Approach two
One plan from a private company that bundles Part A and Part B.
You choose one or the other. Medigap can't be used to cover costs in a Medicare Advantage plan.
Side by side
Plan types
Medicare Advantage Plans are offered by Medicare-approved private companies that must follow rules set by Medicare. They come in several types.
HMO
You generally get care from doctors, other providers and hospitals in the plan's network, except for emergency, urgent care or out-of-area dialysis. In most cases you need a referral to see a specialist.
PPO
You can generally go to out-of-network providers for covered services. You don't need a referral to see a specialist.
PFFS
You can go to any Medicare-approved provider that accepts the plan's payment terms, agrees to treat you and hasn't opted out of Medicare. Your provider can choose at every visit whether to accept the plan's terms. No referral is needed.
MSA
A consumer-directed type of Medicare Advantage Plan. MSA Plans generally don't have network providers, and no referral is needed. Not everyone can join, for example people eligible for Medicaid or getting hospice care.
SNP
For people with certain chronic conditions, people eligible for both Medicare and Medicaid, or people who need the level of care a facility offers. Types: D-SNP, C-SNP and I-SNP.
See Special Needs Plans
Some types of Medicare health plans aren't Medicare Advantage Plans, but are still part of Medicare.
Only available in certain, limited areas. You can generally join when a plan is accepting new members, even if you only have Part B, and leave at any time to return to Original Medicare.
The Program of All-inclusive Care for the Elderly is a Medicare-Medicaid program that helps people meet health care needs in the community.
Special projects that test improvements in Medicare coverage, payment and quality of care. They're usually only available for a limited time, for a specific group of people, or in specific areas.
Not every type is offered everywhere. A Licensed Insurance Agent can tell you which are available where you live, or you can compare plans in your area on your own.
More to consider
What Original Medicare covers on its own and what it doesn't.
Dental
Sometimes covered
Some dental services closely related to certain covered services, like a heart valve repair or replacement, an organ transplant, cancer-related treatments, or dialysis for End-Stage Renal Disease.
Not covered
In most cases, routine cleanings, fillings, tooth extractions and dentures.
Vision
Covered
One pair of eyeglasses with standard frames (or one set of contact lenses) after each cataract surgery that implants an intraocular lens. A glaucoma screening once every 12 months if you're at high risk.
Not covered
Eye exams for prescription eyeglasses and contact lenses. Glasses and contacts usually aren't covered either.
Hearing
Covered
Diagnostic hearing and balance exams when your doctor or health care provider orders them to find out if you need medical treatment.
Not covered
Hearing aids, and exams for fitting them.
Medicare Advantage
Dual Eligible Special Needs Plan
For people who are eligible for both Medicare and Medicaid.
Eligibility depends on Medicaid. Your state Medicaid office can confirm yours.
Medicare Advantage
Chronic Condition Special Needs Plan
For people with specific severe or disabling chronic conditions, like diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure or dementia.
Plans may limit membership to a single chronic condition or a group of related chronic conditions.
Which conditions qualify depends on the plan.
Medicare Advantage
Institutional Special Needs Plan
For people who live in the community but need the level of care a facility offers, or who live (or are expected to live) for at least 90 days in a row in a facility like a nursing facility, skilled nursing facility, long-term care hospital or rehabilitation hospital.
Other facilities that offer similar long-term care can also count.
Good to know
You aren't required to join a Special Needs Plan, and you must live in a plan's service area to join one.
Not sure what applies to you?
A Licensed Insurance Agent can go through it with you, or you can compare plans in your area on your own.
Sources: Medicare & You 2027 (official handbook) pp.44-45, 58, 66, 73-74, 83. Rules can change; Medicare.gov has the latest.
Questions to ask yourself
There's no right answer for everyone. These questions usually decide it.
Which doctors and hospitals do you want to keep seeing, and are they in a plan's network?
Which drugs do you take, and how does each plan cover them?
Would you rather pay more each month, or more when you actually get care?
Do you spend time away from home, in or outside the U.S.?
One thing to remember
Switching later isn't always simple. If you drop a Medigap policy to join a Medicare Advantage plan, you may not be able to get the same policy back later. In California, see the Birthday Rule.
Next
Most people aren't, and it depends on details rather than opinion.
Talk it through
Get Medicare helpA Licensed Insurance Agent can walk you through your options. There is no obligation to enroll.Get help →On your own
Find plans myselfStart comparing plans on your own, at your own pace.Find plans →Not sure where to start? Answer two questions
Sources: Medicare & You 2027 (official handbook) pp.10-12, 82-83. Rules can change; Medicare.gov has the latest.
