Last reviewed: September 2026
The two main paths
There are two main ways to get your Medicare coverage:
- Original Medicare, plus a Medicare Supplement (Medigap) plan, plus a Part D plan
- A Medicare Advantage plan, which usually includes drug coverage
How they compare
| Topic | Original Medicare + Medigap + Part D | Medicare Advantage |
|---|---|---|
| Choosing doctors | Any doctor or hospital in the U.S. that accepts Medicare | Usually a plan network, with rules that vary by plan type |
| Monthly premiums | Part B premium + Medigap premium + Part D premium | Part B premium + the plan’s premium (varies) |
| Costs when you get care | Depends on the Medigap plan letter; often low and predictable | Copays and coinsurance, up to the plan’s yearly out-of-pocket limit |
| Prescription drugs | Separate Part D plan | Usually included |
| Extra benefits | Not included; stand-alone dental/vision/hearing plans are available | Many plans include some; varies by plan |
| Travel | Works anywhere in the U.S.; some plans include limited foreign travel emergency coverage | Emergency and urgent care anywhere in the U.S.; routine care usually in the network/service area |
| Referrals and prior authorization | Generally not required by Original Medicare | May be required |
| Changing later | Moving to Medigap later may require medical underwriting in most states | You can change plans during the Annual Enrollment Period |
Why the choice at 65 matters
In most states, switching from Medicare Advantage to a Medigap plan later may require medical underwriting, except in guaranteed issue situations, such as the first-year trial right.
There’s no one right answer
The right path depends on your priorities, not on which option is objectively better. Questions worth asking yourself:
- How important is being able to choose any doctor?
- Do you travel often, or live in two states?
- Do you prefer predictable costs, or a lower premium?
- Do you want everything — medical and drug coverage — combined in one plan?
How I can help
There’s no single right choice here, only the right choice for you. I’ll walk through both paths side by side, based on your doctors, prescriptions, and priorities. Schedule a review to compare your options.
Talk it through with a licensed agent
Have questions about how this applies to you? Let's go over your options together.
Evening and weekend appointments available.