Medicare Advantage vs. Medigap: How to Choose at 65

Key takeaways

• Medicare Advantage (Part C) replaces how you get Original Medicare benefits, usually with a network, low premiums and an annual out-of-pocket maximum.
• Medicare Supplement (Medigap) works alongside Original Medicare to cover most out-of-pocket costs, lets you see any provider that accepts Medicare, and costs more each month.
• Timing matters: during your Medigap Open Enrollment Period, federal law guarantees you can buy any Medigap plan sold in your state, regardless of health.

The two paths

When you turn 65, you choose between two main ways to get Medicare:

1. Original Medicare (Parts A and B), usually paired with a Medigap plan and a Part D drug plan.
2. Medicare Advantage (Part C), a private plan that bundles Parts A and B — and usually D — into one plan.

Either way you still pay your Part B premium.

Side-by-side comparison

Who Medicare Advantage tends to fit

• You want a low monthly premium and are comfortable with copays when you use care.
• Your doctors are in the plan's network.
• You like having extras such as dental and vision in one plan.
• You mostly get care close to home.

Who Medigap tends to fit

• You want predictable costs and can budget a higher premium.
• You want to see any doctor or specialist that accepts Medicare, without network rules.
• You travel or split time between states.
• You have ongoing health needs and want to limit surprise bills.

Plan G vs. Plan N

The two most popular Medigap plans for new enrollees are Plan G and Plan N. Plan G covers everything except the Part B deductible. Plan N usually has a lower premium but has copays of up to $20 for some office visits and up to $50 for emergency room visits that don't lead to admission, and it doesn't cover Part B excess charges.

Why timing matters

Your Medigap Open Enrollment Period is the 6 months that start when you're 65 or older and enrolled in Part B. During that window, insurers can't use your health history to deny you or charge you more. After it ends, most states allow insurers to use medical underwriting — which is why switching from Medicare Advantage back to Medigap later isn't always possible.

Other key dates:

• Initial Enrollment Period: the 7-month window around your 65th birthday.
• Annual Enrollment Period: October 15 – December 7, to change Advantage or Part D plans for January 1.
• Medicare Advantage Open Enrollment: January 1 – March 31, one switch for people already in an Advantage plan.

The bottom line

There's no single right answer — it depends on your doctors, prescriptions, budget, health and how you like to get care. A licensed agent can compare the plans available in your ZIP code side by side and check your doctors and drugs before you decide.