Which plan actually costs you less, Medigap or Medicare Advantage? The honest answer is: it depends on how much care you use. This post runs the numbers for three real-life health scenarios so you can see where each plan wins.
How we built the numbers
Each scenario shows the total cost of care for one year. That means premiums, deductibles, copays, and coinsurance all added together. The Medigap column assumes Plan G plus a basic Part D drug plan. The Advantage column assumes a typical zero-premium HMO plan with built-in Part D.
Everyone also pays the Part B premium, which is $202.90 a month in 2026. CMS has not announced the 2027 figure yet, so we use the 2026 number as a stable base. Your real costs depend on your state, your health, and the plan you pick.
Scenario 1: Healthy senior
Picture a 68 year old who sees the primary care doctor twice a year, picks up two generic drugs, and gets a flu shot. Nothing dramatic.
Medigap Plan G total: about $3,700
- Part B premium: $2,435 (12 months of $202.90)
- Plan G premium: about $1,800 a year ($150 a month, average 65 year old)
- Part D premium: about $420 a year ($35 a month)
- Doctor and drug copays: about $100
- Total: around $4,755 if you include Part B, or $3,700 if you look at only the extra Medicare cost beyond Part B
Medicare Advantage total: about $1,800
- Plan premium: $0 (common for a basic HMO)
- Doctor copays: about $80 (two $20 primary care visits plus one specialist)
- Drug copays: about $100
- Total extra Medicare cost beyond Part B: around $1,800
Advantage wins here. If you barely use the healthcare system, the low premium is hard to beat.
Scenario 2: Moderate care user
A 72 year old with high blood pressure and arthritis. Four doctor visits a year, two specialist visits, imaging once, and five brand name prescriptions.
Medigap Plan G total: about $4,500
- Plan G premium: $1,800
- Part D premium: $540
- Part B deductible: $257
- Drug copays and tier 3 brand splits: about $900
- Dental and vision out of pocket: $1,000
- Total extra Medicare cost: about $4,500
Medicare Advantage total: about $4,100
- Plan premium: $0
- Specialist copays: about $300 ($45 per visit, six visits)
- Primary care and imaging: $300
- Prior auth delays: hard to price, but real
- Drug copays with tier 3 brands: about $1,500
- Dental and vision used through plan allowance: $0 to $2,000 depending on plan
- Total extra Medicare cost: about $4,100
Call this a tie. Both land in the same neighborhood. The real difference is the Advantage plan comes with prior authorization headaches and a narrower network. The Medigap plan is pure flexibility.
Scenario 3: High needs year
A 76 year old has a knee replacement, two weeks of physical therapy, two hospital admissions during the year, and starts a $200 a month brand name drug. This is where the plans split hard.
Medigap Plan G total: about $5,500
- Plan G premium: $2,100 (higher for age 76)
- Part D premium: $540
- Part B deductible: $257
- Hospital and surgery out of pocket: $0 (Plan G covers it)
- Drug plan out of pocket, capped at $2,000 in 2026: $2,000
- Dental and vision out of pocket: $600
- Total extra Medicare cost: about $5,500
Medicare Advantage total: about $11,350
- Plan premium: $0
- Hospital copays (two admits): $2,000
- Surgery and anesthesia copays: about $1,500
- Physical therapy copays: $500
- Specialist and primary visits: $500
- Advantage plan max out of pocket reached: $8,850 for in-network care
- Drug plan out of pocket: $2,000 at the Part D cap
- Total extra Medicare cost: close to the $8,850 cap plus drug costs. Around $11,350 all in.
This is where Medigap pays for itself. A single hard year can cost twice as much on Advantage.
Side-by-side feature table
| Feature | Medigap Plan G | Medicare Advantage |
|---|---|---|
| Monthly premium (plan only) | $130 to $200 | $0 to $100 |
| Doctor copay | $0 after Part B deductible | $0 to $25 |
| Specialist copay | $0 after Part B deductible | $30 to $65 |
| Annual deductible | $257 Part B deductible only | Often $0, sometimes a drug deductible |
| Max out of pocket | Essentially $0 after deductible | $9,350 in-network cap in 2026 |
| Prescription coverage | Separate Part D plan | Built in to most plans |
| Dental, vision, hearing | Not included, buy separately | Limited allowance included |
| Doctor network | Any Medicare doctor, nationwide | Plan network, usually local |
| Prior authorization | Almost never | Common for procedures and imaging |
| Travel coverage | In every state, plus foreign travel emergency | Usually emergency only outside your area |
How to read the numbers for your own situation
Three things decide which plan wins for you.
The first is how much care you use. If you are healthy, Advantage is almost always cheaper. If you have real health conditions or you expect a procedure, Medigap gets more attractive fast.
The second is doctor choice. If you have a doctor you want to keep, check if they take your Advantage plan. If they do, great. If not, Medigap gives you access to any Medicare doctor in the country.
The third is travel. Snowbirds and road trip retirees usually prefer Medigap because the coverage follows them anywhere. Advantage HMO plans only cover emergencies outside your area.
What about the plan quality score?
Advantage plans get a star rating from CMS, from 1 to 5 stars. The rating goes up for better customer service, fewer denials, and better preventive care. A 4 or 5 star plan is a safer pick than a 2 or 3 star plan.
Medigap plans do not get a star rating because they do not have a network or deny claims. If Medicare pays, Medigap pays its share. That is one less thing to shop.
Prescriptions change the math
The 2026 Part D out of pocket cap is $2,000 a year. That cap applies to both standalone Part D and the drug portion of an Advantage plan. If you take expensive brand name drugs, you hit the cap under either plan.
CMS has not announced the 2027 Part D figures yet. The 2026 cap gives you a safe planning floor. See our insulin cap guide and our GLP-1 drug coverage article for details on the newer rules.
The switch problem
People think they can start with Advantage and switch to Medigap if their health changes. That is true in theory. In practice, it depends on when and where you live.
During your first six months on Part B, you have guaranteed issue for Medigap. The company must sell you a plan at the standard rate. After that six months, in most states, the Medigap carrier can turn you down for health reasons. Our guide on switching Medigap covers the exceptions.
If you are leaning toward Advantage because the premium is low, understand that going back later may not be as simple as it sounds.
Bottom line
Medicare Advantage usually wins on monthly cost. Medigap Plan G usually wins when you actually need care. Both are solid plans run by real companies. The right pick depends on your health, your doctors, and how much financial surprise you can absorb.
Need help running the numbers for your real situation and your state? Book a free call. For the official rules, see Medicare.gov's Medigap page.
Frequently asked questions
Is Medigap or Medicare Advantage cheaper?
Depends on your health. Advantage usually costs less in a healthy year. Medigap usually costs less in a heavy care year.
What is the max out-of-pocket for Medicare Advantage in 2026?
The federal in-network cap is $9,350. Plans can set lower caps. Out-of-network costs on PPO plans have a separate, higher cap.
What does Medigap Plan G cover?
Almost everything after the Part B deductible ($257 in 2026). Hospital, coinsurance, excess charges, and foreign travel emergency. Drugs come from a separate Part D plan.
Can I switch from Medicare Advantage to Medigap later?
You can try. Outside your first six months on Part B, the Medigap company can decline you for health in most states.
Which plan has better doctor choice?
Medigap, by far. Any doctor nationwide who takes Medicare. Advantage uses local networks.
Does either plan cover prescription drugs?
Advantage usually bundles Part D. Medigap requires a separate Part D plan. Costs end up similar either way.