Start with the fork in the road
Once you have Original Medicare (Parts A and B), you face one big decision: bundle everything into a Medicare Advantage plan, or keep Original Medicare and back it up with a Medicare Supplement plus a Part D drug plan. Nearly everything else flows from that choice.
Neither path is universally better. Advantage plans trade network rules for low premiums and built-in extras. Supplements trade a higher fixed premium for near-total freedom and predictable costs. Anyone who tells you one answer fits everybody is selling, not teaching.
| What matters to you | Medicare Advantage | Medigap + Part D |
|---|---|---|
| Monthly premium | Often $0 to low (plus your Part B premium of $202.90 in 2026) | Medigap premium plus Part D premium, plus Part B |
| Doctor choice | Plan network; referrals may apply | Any U.S. doctor that accepts Medicare |
| Costs when you use care | Copays and coinsurance up to a yearly out-of-pocket maximum | Little to nothing beyond the premium on most plans |
| Drug coverage | Usually built in | Separate Part D plan required |
| Extras (dental, vision, hearing) | Often included in some form | Purchased separately as add-ons |
| Travel and snowbirds | Emergency care covered; routine care usually tied to service area | Coverage follows you nationwide |
| Underwriting risk later | Can switch plans every year, no health questions | Easiest to buy in your first 6 months on Part B |
The four building blocks
Medicare Advantage (Part C)
Private plans that replace how you receive your Part A and B benefits, usually adding drug coverage and extras like dental allowances. Strong fit for people whose doctors are in network, who like one card and one bill, and who want a low premium.
Medicare Supplement (Medigap)
Standardized plans, lettered A through N, that pay the deductibles and 20 percent coinsurance Original Medicare leaves behind. Strong fit for frequent travelers, snowbirds splitting the year between states, and anyone who wants to choose any specialist without a referral.
Part D prescription drug plans
Stand-alone drug coverage with a 2026 out-of-pocket cap of $2,100. The cheapest premium is often the most expensive plan once your actual prescriptions are priced, so we always run your exact drug list.
Add-on coverage
Dental, vision and hearing plans, hospital indemnity, cancer and heart plans, and final expense life insurance. Not everyone needs these; the ones you do need are usually cheaper than people expect.
The decision you make in your first year on Medicare can lock in your options for decades, because Medigap gets harder to buy once you need health approval. Get the first choice right and every later choice stays open.