Medicare 2026

Original Medicare + Medigap or Advantage? How to Think It Through

MOBILE, Ala. — With the Medicare Annual Enrollment Period running through Dec. 7, many people in Mobile are once again wrestling with the same fork in the road: stay with Original Medicare and add a Medigap policy, or choose a Medicare Advantage plan instead. The two paths are built very differently, and knowing how they are structured is the first step to picking what fits your life.

Key takeaways

• Original Medicare (Parts A and B) is the federal program; Medigap and Part D are separate policies you add on to fill gaps.
• Medicare Advantage (Part C) is a private plan that replaces how you get Parts A and B, usually bundles drug coverage, and uses networks.
• The Annual Enrollment Period ends Dec. 7, and Medicare Advantage members get a second window from Jan. 1 to March 31 to change course.
• In 2026, Part D has a $2,100 out-of-pocket cap and a maximum deductible of $615; in 2027, the cap is $2,400 and the maximum deductible is $700, no matter which path you choose.

Two very different structures

Original Medicare is the traditional, government-run program. Part A covers hospital stays and Part B covers doctor visits and outpatient care. You can see any provider in the country that accepts Medicare, and there is no network. But Original Medicare by itself has no cap on what you might pay out of pocket, and it does not include prescription drugs.

That is why most people who stay with Original Medicare add two things: a Medigap (Medicare Supplement) policy to help pay the deductibles and coinsurance Medicare leaves behind, and a stand-alone Part D plan for their prescriptions.

Medicare Advantage, sometimes called Part C, works differently. You are still in Medicare, but a private insurance company manages your Part A and Part B benefits. Most Advantage plans also include Part D drug coverage and may add extras like dental, vision, or hearing. In exchange, they usually ask you to use a network of doctors and hospitals and to get referrals or prior approval for certain services.

What each path tends to feel like day to day

With Original Medicare plus Medigap, the tradeoff is usually a higher monthly premium in exchange for very predictable costs at the doctor’s office and broad access to providers. If you travel often or split time between states, that flexibility matters.

With Medicare Advantage, premiums are often lower, but you may pay copays as you use care, and you generally need to stay in-network. Plans set their own rules on referrals and prior authorization. Every plan also has an annual out-of-pocket maximum for medical care, which Original Medicare alone does not have.

Neither structure is “better.” They solve the same problem in different ways.

Prescription drugs in 2027

No matter which path you pick, the Part D rules are the same in 2027:

• The Part D out-of-pocket cap is $2,400 in 2027. Once your drug spending hits that limit, you pay nothing for covered drugs the rest of the year.
• The maximum Part D deductible is $700 in 2027, though many plans set it lower.
• The old coverage gap, or “donut hole,” is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs into level monthly payments through your plan, instead of paying big amounts at the pharmacy counter.

If your income is above $109,000 as a single filer in 2026, an IRMAA surcharge may be added to your Part B and Part D premiums.

Plan availability in Mobile County

Mobile is in Mobile County, and Medicare Advantage and Part D plan availability is set at the county level. That means two neighbors on opposite sides of the county line can see different lists of plans, even though they live minutes apart. When you compare options on Medicare’s Plan Finder, use your ZIP code so the results match what is actually offered where you live.

If you already have a Medigap policy, know that switching in and out of Medigap later can involve medical underwriting, depending on when you first signed up and your situation. That is one reason this decision deserves a careful look and not a rushed click.

Deadlines to keep on your calendar

• Oct. 15 – Dec. 7: Medicare Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment Period. If you are already in an Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare (and add a Part D plan).

Where to get unbiased help

You do not have to figure this out alone, and you should not rely on a mailer or a TV ad to make the call.

• Visit medicare.gov for plan comparisons, official rules, and the Plan Finder tool.
• Call 1-800-MEDICARE (1-800-633-4227), available 24/7.
• Contact Alabama SHIP, the State Health Insurance Assistance Program, for free one-on-one counseling from trained volunteers who do not sell insurance.