Open enrollment season brings a flood of slick ads promising free dental, vision, and grocery cards through Medicare Advantage.
What those commercials rarely mention is the trade-off buried in the fine print: a cap on how much you can be billed each year, but a cap that can still run into the thousands.
Traditional Medicare plus a Medigap supplement works differently.
You pay a monthly premium, but once you're enrolled, most of your out-of-pocket costs are covered.
The catch is that supplement premiums can run $100 to $250 a month or more depending on your age and state, and they don't include prescription drug coverage.
The real gap shows up in worst-case scenarios.
Medicare Advantage plans cap annual out-of-pocket spending, but those caps hit $8,000 or more for in-network care on some plans, and higher for out-of-network.
A Medigap Plan G holder, by contrast, typically faces only the Part B deductible — about $240 in 2025 — before coverage kicks in fully.
There's another wrinkle that catches people off guard.
Medicare Advantage plans often use prior authorization and narrow networks.
Your doctor may be in-network this year and gone the next.
Referrals for specialists can add weeks of delay.
Original Medicare with a supplement lets you see any provider nationwide who accepts Medicare.
Most Medicare Advantage plans bundle prescriptions into the premium, which can be as low as $0.
Standalone Part D plans cost extra on top of a supplement, so Advantage plans often win on total monthly cost for relatively healthy enrollees who take few medications.
The decision comes down to how much risk you can absorb.
If you can handle a surprise $6,000 hospital bill, Advantage's lower premiums might pencil out.
If a single hospitalization would wreck your budget, the supplement's predictable premium may be worth it.
In most states, you can move from Original Medicare to Advantage anytime during open enrollment.
Going the other way is harder — Medigap insurers in most states can charge you more or deny coverage based on health history after your initial enrollment window closes.
That one-way door is why financial planners often tell healthier enrollees to weigh the long game, not just this year's premium.
Before you decide, add up the worst case, not the best case.
Read the plan's annual out-of-pocket maximum, check whether your doctors are in-network, and price a supplement in your ZIP code.
The plan that looks cheapest in October may not be the one that protects you in July.
Our take: the marketing around Medicare Advantage is designed to make the low premium feel like free money, but it's really a bet that you won't get seriously sick.
Final Thoughts
For many households, paying more each month for a supplement buys something worth having — a ceiling on the damage a bad health year can do.