Choosing and changing coverage
What is the difference between Original Medicare and Medicare Advantage?
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Short answer
Original Medicare (Parts A and B) is run by the federal government and lets you see any doctor or hospital in the U.S. that accepts Medicare, but it has no yearly out-of-pocket limit, so many people add a Medigap policy and a Part D drug plan.
Medicare Advantage (Part C) plans are offered by private companies approved by Medicare; they usually use provider networks and may require referrals or prior approval, and most include drug coverage.
Medicare Advantage plans must cap in-network out-of-pocket costs, at no more than $9,250 in 2026, and often add some dental, vision or hearing benefits.
How do Original Medicare and Medicare Advantage compare?
| Original Medicare | Medicare Advantage | |
|---|---|---|
| Who runs it | The federal government | Private companies approved by Medicare |
| Doctors and hospitals | Any provider in the U.S. that accepts Medicare | Usually a network; going outside may cost more or not be covered |
| Referrals and prior approval | Generally not needed | Often needed for specialists and some services |
| Yearly out-of-pocket limit | None | Required; no higher than $9,250 in network (2026) |
| Drug coverage | Add a stand-alone Part D plan | Usually included |
| Dental, vision, hearing | Mostly not covered | Often some benefits, varying by plan |
| Supplemental coverage | Medigap can pay most cost sharing | Medigap can't be used |
| Care while traveling in the U.S. | Covered anywhere in the U.S. | Emergencies covered; routine care usually in the plan's area |
How do costs compare?
With Original Medicare you pay the Part B premium ($202.90 a month in 2026), the deductibles and generally 20% of the cost of Part B services with no yearly limit, plus premiums for a Part D plan and, if you buy one, a Medigap policy. Medigap usually means a higher monthly premium and little to pay when you use care.
With Medicare Advantage you pay the Part B premium plus the plan's premium, if any (some plans charge none), and copays or coinsurance as you use care, up to the plan's out-of-pocket limit. Which costs less depends on your health, the care you use and the plans where you live.
What about my doctors?
Original Medicare works with any doctor or hospital that accepts Medicare, anywhere in the U.S. Medicare Advantage HMOs generally cover care only from network providers except in emergencies; PPOs cover out-of-network care at a higher cost. Before you join a plan, check that your doctors, hospitals and pharmacies are in its network for the coming year.
Can I switch between them later?
You can move between Original Medicare and Medicare Advantage during the Annual Enrollment Period (October 15 to December 7), and people in Medicare Advantage get one more change from January 1 to March 31. The catch is Medigap: outside your first enrollment window or a guaranteed issue right, an insurer can turn you down because of your health. Switching from Medicare Advantage to Medigap.
How many people choose each?
About 54% of people with Medicare are in Medicare Advantage plans, according to CMS enrollment data; the rest have Original Medicare, many with a Medigap policy or retiree coverage. The share varies widely by county: Medicare Advantage by state and county.
On this site: Medicare Advantage plans by stateMedigap plans by state
Good to know
More questions people ask
Can I have both Medicare Advantage and Medigap?
Is Medicare Advantage cheaper than Original Medicare?
Do I still pay the Part B premium with Medicare Advantage?
Does Medicare Advantage cover everything Original Medicare does?
Related questions
In depth
- Medicare.gov: Compare Original Medicare and Medicare Advantage
- Medicare.gov: Your coverage options
- Medicare.gov: Medicare health plans
- Medicare.gov: Medigap (Medicare Supplement Insurance)
Figures are Medicare’s, set nationally, and were checked against these pages on October 2026. For your own situation, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).
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This page was last updated: October 2026.