Medicare 2026
Medigap plus Original Medicare vs. Advantage in Pasadena
PASADENA, Calif. — When you first become eligible for Medicare, you face a choice that shapes how you see doctors, fill prescriptions, and pay bills for years to come. It usually comes down to two paths: stay with Original Medicare and add a Medigap policy (and often a separate Part D drug plan), or enroll in a Medicare Advantage plan that bundles your coverage through a private insurer.
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Key takeaways
- Original Medicare + Medigap and Medicare Advantage are two separate structures — you generally pick one path, not both.
- Medigap helps pay Original Medicare's out-of-pocket costs; Medicare Advantage replaces how you receive Parts A and B through a private plan.
- In 2026, Part D has a $2,100 annual out-of-pocket cap and a maximum $615 deductible; in 2027, the cap is $2,400 and the maximum deductible is $700, whichever path you choose.
- The Annual Enrollment Period runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.
Neither path is universally better. They are built differently, and the right fit depends on your health, your budget, and how you like to get care.
How Original Medicare works
Original Medicare is the federal program itself — Part A (hospital) and Part B (doctor and outpatient). You can see any provider in the country who accepts Medicare, and no network or referral gets in your way.
The trade-off is cost-sharing. Part A has a hospital deductible, Part B has a monthly premium and a 20% coinsurance after its deductible, and there is no annual cap on what you might owe out of pocket. Original Medicare also does not include prescription drug coverage.
Where Medigap fits in
Medigap (also called Medicare Supplement Insurance) is a private policy you buy to sit alongside Original Medicare. It helps pay the deductibles, coinsurance, and copays that Original Medicare leaves behind. Plans are standardized by letter, so a Plan G from one company covers the same core benefits as a Plan G from another.
Medigap does not include drug coverage, so most people on this path also enroll in a stand-alone Part D plan. And Medigap has its own enrollment rules — the strongest protections apply during your six-month Medigap Open Enrollment Period, which starts when you are 65 or older and enrolled in Part B.
How Medicare Advantage works
Medicare Advantage (Part C) is a different structure. A private insurer, approved by Medicare, provides your Part A and Part B benefits — and usually Part D drug coverage — in a single plan. Many plans also include extras like vision, dental, or hearing.
Because these plans are network-based, you generally use in-network doctors and hospitals, and some services require prior approval. In exchange, Advantage plans must set an annual out-of-pocket maximum for medical services, which Original Medicare alone does not offer.
Pasadena is in Los Angeles County, where a wide range of Medicare Advantage plans and carriers are available. Plan availability, networks, and drug lists are set at the county level, so two neighbors in the same ZIP code will see the same menu of options.
What is the same on both paths
No matter which path you pick, the 2027 Part D rules apply to your drug coverage:
- The annual out-of-pocket cap for covered drugs is $2,400.
- The maximum Part D deductible is $700.
- The old coverage gap (“donut hole”) is gone as of 2025 — Part D now has three simpler phases.
- You can opt into the Medicare Prescription Payment Plan, which spreads your drug costs across the calendar year in monthly installments instead of one big pharmacy bill.
Higher-income enrollees may also owe IRMAA, an income-related surcharge that kicks in above $109,000 for a single filer in 2026, based on your 2024 tax return.
How to think about the decision
A few honest questions usually cut through the noise:
- Do you travel or split time between states? Original Medicare + Medigap travels easily, since almost any U.S. provider who takes Medicare will see you.
- Do you prefer predictable monthly costs or lower upfront costs? Medigap tends to mean higher premiums and fewer surprises at the doctor. Advantage plans often have lower premiums but more variable cost-sharing when you use care.
- Do your doctors take the plan? With Advantage, check the network. With Original Medicare, check that the provider accepts Medicare assignment.
- What drugs do you take? Compare each plan's formulary — the same drug can be tiered very differently from one plan to another.
Timing matters too. The Annual Enrollment Period runs Oct. 15 – Dec. 7 each year, when you can join, switch, or drop plans for coverage starting January 1. The Medicare Advantage Open Enrollment Period runs Jan. 1 – March 31, giving Advantage enrollees one chance to switch to another Advantage plan or return to Original Medicare.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Los Angeles County
(MA penetration in Los Angeles County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
Good to know
Frequently asked questions
Can I have both Medicare Advantage and Medigap?
If I choose Medicare Advantage now, can I switch to Medigap later?
Do I need a separate Part D plan on both paths?
Where can I get unbiased help comparing my options?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Pasadena
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This page was last updated: September 29, 2026.