Medicare Advantage vs. Medigap in Maryland: How to Choose
Updated: Oct 12
If you are deciding between Medicare Advantage and Medigap in Maryland, the biggest difference is not simply price. It is how you want to receive your Medicare benefits, how much provider flexibility you want, how predictable you want your medical costs to be, and whether you are comfortable using a plan network.
Medicare Advantage and Medigap solve different problems. Medicare Advantage is an alternative way to receive your Medicare Part A and Part B benefits through a private plan approved by Medicare. Medigap works alongside Original Medicare and helps pay some of the out-of-pocket costs that Original Medicare leaves to you.
Neither option is automatically better for everyone. The right choice depends on your doctors, prescriptions, travel habits, budget, health-care use, and how much flexibility you value.
Medicare Advantage vs. Medigap: The Short Version
With Medicare Advantage, you receive your Part A and Part B benefits through the plan. Most Medicare Advantage plans also include Part D prescription drug coverage, and some offer additional benefits that Original Medicare does not cover, such as certain dental, vision, or hearing benefits. Plan benefits, networks, costs, and rules vary by plan and can change from year to year.
With Medigap, you stay in Original Medicare. The Medigap policy helps cover some of your share of Medicare-approved costs, such as deductibles, copayments, or coinsurance, depending on the standardized Medigap plan you choose. If you want prescription drug coverage, you generally add a separate Medicare Part D plan.
How Medicare Advantage Works
Medicare Advantage plans are offered by private insurance companies that contract with Medicare. You must continue paying your Medicare Part B premium, and the Medicare Advantage plan may have its own premium, deductible, copayments, or coinsurance.
One important feature is that Medicare Advantage plans have an annual limit on what you pay out of pocket for covered Part A and Part B services. Once you reach the plan's limit, the plan pays 100% of covered medical services for the rest of that year. The exact limit and cost-sharing depend on the plan.
Many Medicare Advantage plans use provider networks. Depending on the plan type, you may need to use in-network doctors and hospitals for the lowest costs, and some plans may require referrals or prior authorization for certain services.
How Medigap Works
Medigap, also called Medicare Supplement Insurance, is private insurance that supplements Original Medicare. You generally need Medicare Part A and Part B to buy a Medigap policy.
Because you remain in Original Medicare, you can generally see any doctor or hospital in the United States that accepts Medicare. This can be attractive to people who travel frequently, split time between states, see several specialists, or simply prefer not to rely on a local provider network.
Medigap policies are standardized by letter in most states. That means the basic benefits of a particular standardized plan letter are the same regardless of which insurance company sells it, although premiums and service can differ by insurer.
The Biggest Differences to Compare
1. Provider Choice
Provider access is often one of the most important practical differences. Original Medicare with Medigap generally allows broad access to providers nationwide that accept Medicare. Medicare Advantage plans may use HMO, PPO, or other network structures, so you should verify your doctors, hospitals, and specialists before enrolling.
2. Monthly Premium vs. Pay-As-You-Go Costs
Medigap usually adds a separate monthly premium on top of your Part B premium, and you may also pay a separate Part D premium. In exchange, depending on the Medigap plan, many Medicare-approved medical costs can become more predictable.
Medicare Advantage may have a lower additional monthly premium, but you can have copayments or coinsurance as you use medical services. A low premium does not necessarily mean the lowest total annual cost, especially if you expect frequent care.
3. Prescription Drug Coverage
Most Medicare Advantage plans include Part D prescription drug coverage. Medigap policies sold today do not include prescription drug coverage, so someone using Original Medicare and Medigap will generally need to select a separate Part D plan if they want Medicare drug coverage.
In either case, checking your actual prescriptions matters. Formularies, pharmacy networks, and drug costs can differ from one Part D or Medicare Advantage prescription drug plan to another.
4. Extra Benefits
Some Medicare Advantage plans include benefits beyond what Original Medicare covers, which may include dental, vision, hearing, fitness, transportation, or other supplemental benefits. These benefits vary substantially by plan and service area and should be evaluated based on what you are actually likely to use.
Medigap's main purpose is different: it helps reduce certain out-of-pocket costs associated with Original Medicare. It should not be evaluated as though it were an all-in-one Medicare Advantage plan.
5. Travel and Living in More Than One State
If you spend significant time outside Maryland, provider access deserves extra attention. Original Medicare is a federal program, so Original Medicare plus Medigap can be simpler for people who regularly receive care in different states, provided the providers accept Medicare.
Medicare Advantage plans can still cover emergencies and urgently needed care outside their service area, but routine non-emergency care may depend on the plan's network and rules. Frequent travelers should review those rules carefully before choosing a plan.
A Maryland-Specific Medigap Change in 2026
Maryland residents should also know about a state law that took effect July 1, 2026. The Maryland Insurance Administration says the law created new guaranteed-issue opportunities for certain Medicare beneficiaries to buy specified Medicare Supplement policies without medical underwriting.
One new protection applies in certain situations when a person loses Medicaid after having both Medicaid and Medicare Part B for the required period. Maryland also created an annual birthday-related enrollment right for certain existing Medigap policyholders to move to a policy with the same or lesser benefits without medical underwriting, subject to the law's requirements.
These state protections are important because the federal Medigap Open Enrollment Period is generally a one-time six-month period beginning when you are 65 or older and enrolled in Part B. Outside protected enrollment rights, a person may face medical underwriting or may not be able to buy the Medigap policy they want.
Can You Have Medicare Advantage and Medigap at the Same Time?
No. Medigap is designed to supplement Original Medicare, not Medicare Advantage. It is illegal for an insurer to sell you a Medigap policy if it knows you are enrolled in Medicare Advantage unless you are switching back to Original Medicare and the Medigap coverage will begin after the Medicare Advantage coverage ends.
There are specific guaranteed-issue and trial-right situations that can protect some people who move from Medicare Advantage back to Original Medicare, but the rules depend on the circumstances and timing.
Which Option May Fit You Better?
Medicare Advantage may deserve a closer look if you are comfortable with a plan network, want an all-in-one structure that usually includes drug coverage, value certain extra benefits, and prefer to balance potentially lower monthly premiums against copayments and coinsurance when you receive care.
Original Medicare with Medigap may deserve a closer look if broad provider access is a high priority, you travel frequently, you prefer more predictable medical cost-sharing, or you are comfortable paying a separate Medigap premium and selecting a separate Part D plan.
The best comparison is not 'Which one has more benefits?' It is 'Which structure fits the way I actually use health care?'
Questions to Ask Before You Enroll
Before choosing either route, check whether your doctors and preferred hospitals participate, whether your prescriptions are covered and at what cost, what you could realistically pay in a high-use medical year, how often you travel, and whether you would be comfortable changing providers if a network changes.
If you are considering Medigap, also pay close attention to your enrollment rights. Do not assume that because you can switch from Medicare Advantage to Original Medicare during an enrollment period, you will automatically be able to buy any Medigap policy without medical underwriting. Federal and Maryland-specific guaranteed-issue rules can matter.
Frequently Asked Questions
Is Medicare Advantage cheaper than Medigap?
Not necessarily. Medicare Advantage may have a lower additional monthly premium, while Medigap often has a separate monthly premium. Your total cost depends on premiums, health-care use, copayments, coinsurance, prescriptions, and the specific coverage you choose.
Do I still pay Part B with Medicare Advantage or Medigap?
Yes. You generally must continue paying your Medicare Part B premium whether you use Medicare Advantage or Original Medicare with Medigap.
Does Medigap include Part D?
Medigap policies sold today do not include prescription drug coverage. If you want drug coverage while using Original Medicare and Medigap, you generally enroll in a separate Medicare Part D plan.
Can I switch from Medicare Advantage to Medigap later?
You may be able to switch back to Original Medicare during an applicable enrollment period, but your ability to buy a Medigap policy without medical underwriting depends on whether you have a federal or state guaranteed-issue right or another protected enrollment opportunity. Maryland added new Medigap enrollment protections effective July 1, 2026, but they apply only in specified circumstances.
Making the Choice in Maryland
Medicare Advantage and Medigap can both be good ways to manage the gaps left by Original Medicare, but they do it in very different ways. Start with your doctors, medications, expected health-care use, travel, and budget before comparing premiums or extra benefits.
Forest Brook Financial can help Maryland residents compare Medicare Advantage, Medigap, and Part D options in plain English so you can understand the trade-offs before making a decision.
Related guides and official references
Forest Brook Financial is not affiliated with or endorsed by Medicare or any government agency. Plan availability, premiums, provider networks, formularies, benefits, and cost-sharing vary by plan, insurer, service area, and year. Review official plan documents and Medicare information before enrolling.
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