Medigap and Medicare Advantage (MA) handle medical bills in very different ways, and the real cost difference between the two only truly shows up once you actually need care. Medicare Advantage usually costs less every month but has higher out of pocket costs, while Medigap charges a higher premium but leaves you with little or nothing to pay when a hospital bill arrives. Comparing the two by premium alone misses the number that matters most: what you’d actually owe out of pocket in a bad health year. Here’s how the true costs compare for 2026.
Monthly Premiums: Medigap vs Medicare Advantage
Most Medicare Advantage enrollees pay little or nothing beyond their Part B premium ($202.90 a month in 2026). About three-quarters of people in individual Medicare Advantage plans with drug coverage pay no separate premium at all. Source: KFF.
Medigap, also called Medicare Supplement or Medsupp, works differently. You still pay the $202.90 Part B premium, plus a separate Medigap premium that covers Medicare’s cost-sharing gaps (it doesn’t include drug coverage, dental, or vision). Medigap Plan G premiums vary by age, state, gender, tobacco use, and which insurance company you choose (since companies price the exact same lettered plan very differently). Source: Medicare.gov.
What You Actually Pay When You Get Sick
Medicare Advantage plans must cap your yearly out-of-pocket spending on Part A and Part B services, but that cap is higher than most people expect: up to $9,250 for in-network care alone in 2026, and up to $13,900 if a PPO plan lets you use out-of-network providers. In practice, the average Medicare Advantage out-of-pocket limit can be lower but on average is over $5000. Source: KFF.
Medigap Plan G works the opposite way. Once you’ve paid the $283 Part B deductible for the year, Plan G covers your remaining co-insurnace in full. There’s no $13,900 worst-case out of pocket, because there’s almost nothing left for Medicare to bill you. Note: Plan N premium costs a little less than Plan G but leaves small copays for some office and emergency room visits. Source: Medicare.gov.
| Cost Factor | Medicare Advantage (MA) | Medigap Plan G |
|---|---|---|
| Monthly premium | $0-$59 on average, plus $202.90 Part B premium | Varies by age/state/carrier, plus $202.90 Part B premium |
| Yearly out-of-pocket limit | Up to $9,250 in-network ($13,900 combined for PPOs) | Effectively just the $283 Part B deductible |
| Provider network | Limited; typically less than half the physicians available under Original Medicare | Any provider that accepts Medicare |
| Prior authorization | Required by 99% of plans for some services | Not used |
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Medicare Advantage Prior Authorization Add to the Real Cost
Medicare Advantage plans also manage costs with tools Medigap doesn’t use. Nearly every enrollee (99%) is in a plan that requires prior authorization for at least some services, most often inpatient hospital stays, skilled nursing facility care, and Part B drugs. In 2024, insurers processed close to 53 million prior authorization requests and denied about 8% of them. Source: KFF.
In contrast, there are no prior authorizations required allowed from your Medigap plan. They have no say in your healthcare decisions.
Provider Access Between Medigap and MA is different
Medicare Advantage networks are also narrower. On average, enrollees have access to about half the physicians available to someone on Original Medicare. Source: KFF.
Medigap doesn’t use networks so if a provider accepts Medicare, they accept your Medigap plan too.
So Which Actually Costs More, Medigap or Medicare Advantage?
For a healthy year with few doctor visits, Medicare Advantage is usually cheaper month to month. For a year involving a hospital stay, surgery, or ongoing treatment, Medigap can usually save you money over MA. Medigap trades a predictable, higher monthly cost for protection against the unpredictable, expensive year, and Medicare Advantage does the reverse. We typically recommend Medigap for anyone managing an ongoing condition or who values having access to the largest network of doctors in the nation.
💡 Tip: If you’re already on Medicare Advantage and want to move to Medigap, medical underwriting is usually required outside your Initial Enrollment Period. Approval is possible even with some pre-existing conditions, though it’s never guaranteed. Our Instant Medigap Underwriting Checker can give you if you will be approved. Our Medicare switching guide walks through the rest of the process.
Compare Your Actual Numbers
National averages only go so far. Medigap premiums and Medicare Advantage plan options both vary by ZIP code, so the only way to know which costs less where you live is to compare real numbers side by side. Senior65 doesn’t sell Medicare Advantage, so you can get prices for MA at Medicare.gov. There is never a charge to work with Senior65.com. We receive commissions directly from insurance companies, so our prices are the guaranteed lowest allowed by law.
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Call 800-930-7956 to talk through your specific numbers with our team at Senior65.com, or start with our guide for people new to Medicare if you’re still comparing your first-time options.