Medicare 2026

Medicare Advantage or Medigap? Two Paths, One Big Choice

GULFPORT, Miss. — For people signing up for Medicare for the first time, one decision shapes almost everything that follows: whether to stay with Original Medicare and add a Medigap policy, or to get your benefits through a Medicare Advantage plan. The two paths look similar from the outside, but they're built very differently — and switching later isn't always easy.

Here's a plain-language look at how each path works, so you can weigh them with your eyes open.

Path 1: Original Medicare + Medigap (+ usually a Part D plan)

Original Medicare is the federal program itself — Part A (hospital) and Part B (doctor and outpatient care). You can see any doctor or hospital in the country that accepts Medicare, and most do. There's no network and no referral needed to see a specialist.

The catch is that Original Medicare alone doesn't cap what you pay out of pocket. That's where Medigap (also called Medicare Supplement Insurance) comes in. A Medigap policy, sold by a private insurer, helps pay the deductibles, copays, and coinsurance that Original Medicare leaves behind.

Original Medicare also doesn't include prescription drug coverage, so most people on this path also enroll in a stand-alone Part D drug plan.

So the "Medigap path" is really three pieces working together: Original Medicare + a Medigap policy + a Part D plan.

Path 2: Medicare Advantage (Part C)

Medicare Advantage plans are offered by private insurers approved by Medicare. When you enroll in one, the plan takes over as the way you get your Part A and Part B benefits. Most Advantage plans also bundle in Part D drug coverage, and many include extras Original Medicare doesn't cover, such as routine dental, vision, or hearing.

Advantage plans typically use provider networks (HMOs and PPOs are the most common), and they set their own copays, rules, and, in some cases, prior authorization requirements. They also must include an annual out-of-pocket maximum on Part A and Part B services — something Original Medicare by itself does not have.

Gulfport is in Harrison County, where multiple Medicare Advantage plans from several carriers are offered for 2026. You can see the current lineup on Medicare's Plan Finder at medicare.gov.

The structural difference in one sentence

On the Medigap path, Medicare pays your providers first and your Medigap policy fills in the gaps. On the Advantage path, the private plan is the one paying — and it sets the network and rules within limits Medicare requires.

That single difference drives most of the day-to-day experience: which doctors you can see, how referrals work, how you're billed, and what happens if you travel.

The mistake to avoid: assuming you can switch anytime

A lot of new enrollees pick one path thinking they can freely swap later. You often can move between Medicare Advantage plans or drop back to Original Medicare during:

• The Annual Enrollment Period, Oct. 15 – Dec. 7, and
• The Medicare Advantage Open Enrollment Period, Jan. 1 – March 31.

But here's the part people miss: buying a Medigap policy later is not guaranteed. Federal law gives you a one-time Medigap "open enrollment" window when you first sign up for Part B at age 65 or older. During that window, insurers must sell you a policy and can't charge you more for health reasons. Outside that window, in most states — including Mississippi — insurers can use medical underwriting and turn you down or charge more based on your health.

That's why the initial choice deserves careful thought, not a quick decision at the kitchen table.

2026 numbers that apply on both paths

A few Medicare figures are set at the program level and apply no matter which path you choose:

• Part D out-of-pocket cap: $2,100 for 2026. Once your covered drug spending reaches that amount, you pay $0 for covered drugs the rest of the year.
• Part D maximum deductible: $615 (plans can set a lower one).
• The old coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly amounts, at no added cost. You have to opt in.
• IRMAA surcharges on Part B and Part D premiums start above $109,000 in income for a single filer in 2026 (higher for joint filers), based on your 2024 tax return.