Medicare 2026

Original Medicare plus Medigap vs Medicare Advantage in Columbia

COLUMBIA, Tenn. — If you're getting close to 65, or helping a parent sort through Medicare mail, you've probably run into the same fork in the road: stick with Original Medicare and add a Medigap policy, or go with a Medicare Advantage plan? Both are legitimate paths. They just work in very different ways, and understanding the structure up front makes every other decision easier.

Here's a plain-language walk-through of how the two setups are built, what each one asks of you, and where to get personalized help in Columbia.

Two different structures, not two versions of the same thing

Original Medicare is the federal program run directly by the government. It has two main parts: Part A (hospital coverage) and Part B (doctor visits, outpatient care, and most other medical services). You can see almost any doctor or hospital in the country that accepts Medicare, and there's no network to worry about.

Original Medicare doesn't cap what you pay out of pocket in a year, and it doesn't include prescription drug coverage. That's why most people who choose this path add two things:

• A Medigap (Medicare Supplement) policy, sold by a private insurer, that helps pay the deductibles and coinsurance Original Medicare leaves behind.
• A stand-alone Part D plan for prescription drugs.

Medicare Advantage (Part C) is the alternative. Instead of getting Parts A and B directly from the government, you get them bundled through a private plan approved by Medicare. Most Advantage plans also include Part D drug coverage and sometimes extras like dental or vision. In exchange, you typically use a network of doctors and hospitals, and you follow the plan's rules on things like referrals and prior authorization. Advantage plans do have an annual out-of-pocket maximum for medical costs, which Original Medicare alone does not.

The trade-offs, side by side

Think of it this way:

• Original Medicare + Medigap + Part D: more predictable monthly costs, broader provider access, more separate pieces to manage, and usually higher premiums up front.
• Medicare Advantage: one card, coordinated benefits, often lower monthly premiums, but you're working within a network and following plan rules. Costs can vary more when you actually use care.

Neither is "better." What fits depends on how you use health care, whether you travel, whether your doctors are in a given network, and how you feel about paperwork versus prior authorization.

What's changed for 2027 that affects both paths

A few program-level updates are worth knowing, no matter which route you take:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs hit that amount, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 ($700 in 2027). Plans can charge less, but not more.
• No more coverage gap. The old "donut hole" was eliminated in 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan. This is an optional program that lets you spread your drug costs over the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA. Higher-income beneficiaries pay surcharges on Part B and Part D premiums. For 2026, these begin above $109,000 in income for a single filer.

These rules apply whether your drug coverage comes through a stand-alone Part D plan or is baked into a Medicare Advantage plan.

What Columbia residents actually choose from

Columbia is in Maury County, and Medicare plan availability is set at the county level. That means the specific Advantage and Part D plans on your Medicare.gov search results depend on your ZIP code and county, not the city name. If you're comparing options, use the Plan Finder at medicare.gov and enter your ZIP — that's the only way to see the exact plans available where you live.

One important note about Medigap: in Tennessee, Medigap policies are regulated at the state level, and your best window to buy one without medical underwriting is your six-month Medigap Open Enrollment Period, which starts when you're 65 or older and enrolled in Part B. Miss that window, and insurers can generally consider your health history when deciding whether to sell you a policy and at what price.

Key dates to keep on the fridge

• Annual Enrollment Period: October 15 – December 7. This is when anyone with Medicare can join, switch, or drop a Medicare Advantage plan or a Part D plan for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in an Advantage plan, you get one chance during this window to switch to a different Advantage plan or return to Original Medicare (and pick up a Part D plan).
• Your Initial Enrollment Period. A seven-month window around your 65th birthday for first-time enrollment.