Understand My Medicare

Compare Your Medicare Options

Every Medicare beneficiary faces this choice. Here's how the three paths stack up, with no sales pitch.

Most Flexibility

Original Medicare + Medigap

Parts A & B + Medicare Supplement + standalone Part D

All-in-One

Medicare Advantage

Part C plan from a private insurer, usually includes drug coverage

Minimum Coverage

Original Medicare Only

Parts A & B with no supplemental coverage

💰 Monthly Cost

Part B premium + Medigap premium ($100-250/mo depending on plan and location) + Part D premium ($15-80/mo)

Best

Part B premium + plan premium ($0-100/mo for most plans)

Part B premium only

🩺 Doctor Choice
Best

Any doctor or hospital that accepts Medicare, anywhere in the U.S. No referrals needed.

Must use plan's network (HMO) or pay more for out-of-network (PPO). HMOs require referrals.

Any doctor or hospital that accepts Medicare. No referrals.

🏥 Cost at Point of Care
Best

Little to nothing. Medigap covers most copays and coinsurance. Plan G: you pay the $257 Part B deductible, then essentially $0.

Copays for most services ($10-50 for doctor visits, $200-400/day for hospital). Costs vary by plan.

You pay 20% coinsurance for Part B services with no annual cap. Hospital costs add up fast.

🛡 Maximum Out-of-Pocket
Best

Effectively capped. With Plan G, your max medical cost is around $257/year plus your premiums.

Capped by plan's MOOP (typically $3,500-8,300/year for in-network).

No cap. You pay 20% of all Part B costs with no limit.

💊 Drug Coverage

Separate Part D plan required. You choose the best plan for your medications independently.

Best

Usually included (MAPD). Convenient but you can't shop Part D separately.

Must add standalone Part D or face permanent late enrollment penalty.

💫 Extra Benefits

No extras. Dental, vision, hearing, and fitness not included.

Best

Many plans include dental, vision, hearing, gym memberships, meal delivery, transportation.

No extras.

✈ Travel Coverage
Best

Nationwide. Works anywhere a doctor accepts Medicare. Some plans cover foreign travel emergencies.

HMO plans typically limited to service area. PPO plans cover out-of-area at higher cost.

Nationwide for Medicare-accepting providers. No foreign coverage.

📋 Prior Authorization
Best

None. Medicare approves services based on medical necessity. No plan gatekeeping.

Plans can require prior authorization for services, referrals, and certain medications.

None.

🔄 Switching Later

Can switch to MA during AEP. May lose guaranteed Medigap rights if you switch and want to come back.

Can switch back to Original Medicare during AEP or MA OEP. But getting a Medigap policy after leaving may require medical underwriting.

Can add Medigap (may require underwriting) or switch to MA during AEP.

💰 Monthly Cost

Original Medicare + Medigap
Part B premium + Medigap premium ($100-250/mo depending on plan and location) + Part D premium ($15-80/mo)
Medicare Advantage Best
Part B premium + plan premium ($0-100/mo for most plans)
Original Medicare Only
Part B premium only

🩺 Doctor Choice

Original Medicare + Medigap Best
Any doctor or hospital that accepts Medicare, anywhere in the U.S. No referrals needed.
Medicare Advantage
Must use plan's network (HMO) or pay more for out-of-network (PPO). HMOs require referrals.
Original Medicare Only
Any doctor or hospital that accepts Medicare. No referrals.

🏥 Cost at Point of Care

Original Medicare + Medigap Best
Little to nothing. Medigap covers most copays and coinsurance. Plan G: you pay the $257 Part B deductible, then essentially $0.
Medicare Advantage
Copays for most services ($10-50 for doctor visits, $200-400/day for hospital). Costs vary by plan.
Original Medicare Only
You pay 20% coinsurance for Part B services with no annual cap. Hospital costs add up fast.

🛡 Maximum Out-of-Pocket

Original Medicare + Medigap Best
Effectively capped. With Plan G, your max medical cost is around $257/year plus your premiums.
Medicare Advantage
Capped by plan's MOOP (typically $3,500-8,300/year for in-network).
Original Medicare Only
No cap. You pay 20% of all Part B costs with no limit.

💊 Drug Coverage

Original Medicare + Medigap
Separate Part D plan required. You choose the best plan for your medications independently.
Medicare Advantage Best
Usually included (MAPD). Convenient but you can't shop Part D separately.
Original Medicare Only
Must add standalone Part D or face permanent late enrollment penalty.

💫 Extra Benefits

Original Medicare + Medigap
No extras. Dental, vision, hearing, and fitness not included.
Medicare Advantage Best
Many plans include dental, vision, hearing, gym memberships, meal delivery, transportation.
Original Medicare Only
No extras.

✈ Travel Coverage

Original Medicare + Medigap Best
Nationwide. Works anywhere a doctor accepts Medicare. Some plans cover foreign travel emergencies.
Medicare Advantage
HMO plans typically limited to service area. PPO plans cover out-of-area at higher cost.
Original Medicare Only
Nationwide for Medicare-accepting providers. No foreign coverage.

📋 Prior Authorization

Original Medicare + Medigap Best
None. Medicare approves services based on medical necessity. No plan gatekeeping.
Medicare Advantage
Plans can require prior authorization for services, referrals, and certain medications.
Original Medicare Only
None.

🔄 Switching Later

Original Medicare + Medigap
Can switch to MA during AEP. May lose guaranteed Medigap rights if you switch and want to come back.
Medicare Advantage
Can switch back to Original Medicare during AEP or MA OEP. But getting a Medigap policy after leaving may require medical underwriting.
Original Medicare Only
Can add Medigap (may require underwriting) or switch to MA during AEP.

Medigap Might Be Right If...

  • You want predictable costs with almost no surprises
  • You travel or split time between states
  • You see specialists without wanting referrals
  • You want to keep your current doctors regardless of network changes
  • You prefer paying more monthly to avoid large bills when you're sick
Talk to a Medigap Specialist

Medicare Advantage Might Be Right If...

  • You want lower monthly premiums
  • You value dental, vision, and hearing coverage
  • You're comfortable using a network of doctors
  • You're in good health and don't use much healthcare
  • You want drug coverage bundled with your medical plan

Original Medicare Only Is Usually...

  • Not recommended long-term. The 20% coinsurance with no cap is a major financial risk.
  • Sometimes used temporarily while transitioning between plans
  • Acceptable if you have other coverage (VA, employer, Medicaid) filling the gaps

Understanding Part D Drug Coverage

Your Medications Determine Your Plan

Two Part D plans can cost dramatically different amounts for the same person. The right plan depends on exactly which drugs you take, the dosages, and the pharmacy you use.

Plans Change Every Year

Formularies, tiers, and costs change annually. A plan that was great this year might not be next year. Annual review during AEP is worth the effort.

The $2,100 Cap Is New

Starting in 2025, Part D has a hard out-of-pocket cap. This is a major change that protects people with expensive medications from catastrophic drug costs.

Read the full Part D guide →

Dig Deeper

Each option has more to it than a comparison table can show. Our Learn section breaks down every piece of Medicare so you can make this decision with confidence.

Explore the Guides