Neither fits everyone. A Medigap policy adds to Original Medicare: you can see any doctor who takes Medicare anywhere in the U.S., and you can add a separate Part D plan for drugs. A Medicare Advantage Plan is another way to get Medicare: it may require its network and referrals, usually includes drug coverage and has a yearly out-of-pocket limit. You can't have both at once.
How the two compare
A Medigap policy goes with Original Medicare: it helps pay your share of Original Medicare's costs. So the real choice is Original Medicare plus a Medigap policy, or a Medicare Advantage Plan instead. Want the 2026 premiums and deductibles behind each side? They're in the Medicare costs guide.
| What you're comparing | Original Medicare with Medigap | Medicare Advantage |
|---|---|---|
| Doctors and hospitals | Any doctor or hospital that takes Medicare, anywhere in the U.S. You may pay more if your doctor doesn't accept assignment. | You may need to use doctors in the plan's network and service area for care that isn't an emergency. Some plans cover care out of network, but it may cost more. |
| Referrals | In most cases, no referral is needed to see a specialty doctor. | You may need a referral to see a specialty doctor. |
| Approval before care | In most cases, no prior authorization is needed. | You may need prior authorization from the plan for certain services or supplies. |
| Your share of each bill | Usually 20% of the amount Medicare approves for Part B services after the deductible. Medigap helps pay that share, depending on the plan letter. | Out-of-pocket costs vary by plan, and plans may charge different amounts for certain services. |
| Premiums | The Part B premium, the Medigap premium, and a Part D premium if you join a drug plan. | The Part B premium, and the plan's own premium if it has one. Some plans may help pay all or part of your Part B premium. |
| A yearly limit on what you pay | Original Medicare has none. Medigap pays some or all of your share, depending on the plan letter. | Every plan has a yearly limit on what you pay for covered services. Once you reach it, you pay nothing for covered services for the rest of the year. |
| Drug coverage | Join a separate Medicare drug plan (Part D). Medigap policies sold after 2005 don't include drug coverage. | Most plans include Part D, so you don't join a separate drug plan. |
| Vision, hearing and dental | Original Medicare doesn't cover routine eye exams or most dental care, and Medigap generally doesn't cover vision or dental care or hearing aids. | Plans may offer extra benefits Original Medicare doesn't cover, like some vision, hearing and dental services. |
| Care outside the U.S. | Original Medicare generally doesn't cover it. Several Medigap letters pay 80% of emergency care abroad, up to plan limits. | Plans generally don't cover it. Some offer an extra benefit for emergency and urgently needed care while you travel abroad. |
| Having both | A Medigap policy can't pay a Medicare Advantage Plan's premiums, deductibles or copayments. | You can't buy Medigap to cover your costs while you are in a plan. |
Whichever way you lean, check your own doctors and prescriptions against the specific plan before you join, and again every year. To go deeper on either side, see Medicare Advantage or Medicare Supplement. Weighing two Medigap letters? Here are Plan G and Plan N, compared letter by letter.
The Medigap window, and health questions after it
Medigap
One window, six months, once
Your Medigap Open Enrollment Period starts the first month you are 65 or older and have Part B. During it, a company can't refuse you a policy sold in your state because of health problems.
Medicare Advantage
When you first get Medicare, then each fall
You can join when you first get Medicare, and each year you can join or leave a plan during the Open Enrollment Period, October 15 to December 7.
After your six months, your options to buy a Medigap policy may be limited and the policy may cost more. Outside that window a company can ask health questions and turn you down, or charge more, except in limited situations where the law gives you the right to buy.
Your Medigap Open Enrollment Period doesn't repeat every year. If you start with Medicare Advantage at 65, that window passes while you are in the plan.
Changing your mind later
During the Open Enrollment Period, October 15 to December 7, you can move from Original Medicare to a Medicare Advantage Plan, or from a plan back to Original Medicare, with coverage starting January 1. If you are already in a Medicare Advantage Plan, you can also move to another plan, or back to Original Medicare with a separate drug plan, from January 1 to March 31.
Going back to Original Medicare doesn't by itself let you buy Medigap without health questions. Two situations do give you that right:
- You joined a Medicare Advantage Plan when you were first eligible for Medicare at 65, and you switch to Original Medicare within the first year: you can buy certain Medigap policies sold in your state.
- You dropped a Medigap policy to join a Medicare Advantage Plan for the first time: you have a single twelve-month trial right to get that policy back, if the same company still sells it.
If you drop a Medigap policy to join a plan, cancel it with the Medigap company yourself; most policies don't cancel on their own when you join a Medicare Advantage Plan. Outside the trial right, you may not be able to get the same policy back, or in some cases any Medigap policy.
What people in Florida have chosen
Medicare keeps a monthly count of who's enrolled. In June 2026, CMS counted 5,334,437 people with Medicare in Florida: 3,046,820 in Medicare Advantage and other health plans, and 2,287,617 in Original Medicare.
A count says what people chose, not what fits you. It doesn't show who has a Medigap policy, and your own doctors, prescriptions, travel and budget are what the choice turns on.
Florida public retirees: the state plan first
If you retired from the State of Florida and keep a State Group Insurance health plan, the state's rules come first. A state retiree who buys private Part C, Part D or Medigap coverage should cancel the state group plan, and once it is cancelled it can't be rejoined.
For state retirees who keep the state plan, Medicare pays first once they are eligible and the state plan pays second. If that's you, Medicare for FRS retirees walks through the state's rules step by step.
Questions people ask
Why would someone choose Medigap over Medicare Advantage?
It comes down to a few trade-offs. With Original Medicare and a Medigap policy you can use any doctor or hospital that takes Medicare anywhere in the U.S., in most cases without a referral or prior authorization, and Medigap helps pay your share of costs such as the 20% coinsurance. Several Medigap letters also pay for emergency care abroad. In exchange you pay a Medigap premium and usually add a separate Part D plan. Whether that trade fits depends on your doctors, your travel and your budget.
Can I keep my doctors with Medigap or Medicare Advantage?
With Original Medicare and Medigap, you can see any doctor who takes Medicare, anywhere in the U.S. With a Medicare Advantage Plan you may need to use doctors in the plan's network and service area for care that isn't an emergency, and some plans cover out-of-network care at a higher cost. Before you join a plan, ask each of your doctors whether they are in its network, and check again each year.
Which Medicare option do most people choose?
In Florida, more people are in Medicare Advantage and other health plans than in Original Medicare. In June 2026 CMS counted 3,046,820 people in Medicare Advantage and other health plans and 2,287,617 in Original Medicare, out of 5,334,437 people with Medicare in the state. That count describes what people chose; it doesn't say which fits you.
Can I have both Medigap and a Medicare Advantage plan?
No. When you're getting started with Medicare you can buy Medigap or join a Medicare Advantage Plan, but not both. It's illegal for anyone to sell you a Medigap policy while you have a Medicare Advantage Plan unless you're switching back to Original Medicare, and a Medigap policy can't pay a Medicare Advantage Plan's copayments, deductibles or premiums.
If I start with Medicare Advantage, can I get Medigap later?
Sometimes. If you joined a Medicare Advantage Plan when you were first eligible at 65 and switch to Original Medicare within the first year, you can buy certain Medigap policies. If you dropped a Medigap policy to join a plan for the first time, you have a single twelve-month trial right to get it back if the same company still sells it. Outside those and a few other limited situations, a company doesn't have to sell you a policy, and it may cost more because of your health.
Got another Medicare question, about costs or enrollment periods? Start at the Answers page.