What is the difference between Medicare Advantage and Medigap?

Medicare Advantage replaces Original Medicare with a private plan that bundles your coverage, usually including drugs, with a provider network and copays. Medigap does the opposite: it keeps Original Medicare in place and pays the share Medicare leaves behind, works with any provider who accepts Medicare, and does not include drug coverage.

When can I change my Medicare plan?

The main window is the Annual Enrollment Period, October 15 to December 7 each year, when anyone with Medicare can switch Medicare Advantage or Part D plans for coverage starting January 1. If you are already on a Medicare Advantage plan you get a second window, the Medicare Advantage Open Enrollment Period, from January 1 to March 31.

Can I keep my doctor with Medicare Advantage?

Short answer: Only if that doctor is in the specific plan’s network, which has to be checked plan by plan and year by year. Medicare Advantage plans use provider networks, so two plans from the same insurance company, or the same plan in a different year, can cover different doctors.

Last reviewed: September 14, 2026 · Reviewed by the Personal Touch Ins. & Benefits Data Desk · Figures are 2026 plan year

This is the detail that causes the most regret after enrollment, and it is entirely avoidable by checking first.

Networks are per plan, not per carrier or per hospital system. Assuming that a plan covers a hospital system because the carrier is well known in the area is how people end up out of network. The question is never whether a system is covered in general, it is whether your named physicians and clinics are in that plan’s current directory.

HMO and PPO behave differently. An HMO generally requires you to stay in network for non-emergency care and may require referrals to see specialists. A PPO lets you go out of network at a higher cost. Emergency care is covered either way.

Networks change annually. A provider can leave a network at contract renewal even if nothing changes on your end. That is why the Annual Enrollment Period, October 15 to December 7, exists, and why re-checking your doctors every fall is worth the twenty minutes.

If keeping any doctor matters most. Original Medicare with a Medigap policy has no network at all, so any provider who accepts Medicare accepts the plan anywhere in the country. That is often the better structure for people who travel, split the year between states, or see specialists across systems.

How to check. Use Medicare’s plan finder with your prescriptions and providers, call the plan and ask about your named doctors for the coming plan year, or have an agent verify each one against the plan directory before you enroll.

Sources

When can I join a health or drug plan? (CMS) · accessed September 14, 2026
How to compare Medigap policies (CMS) · accessed September 14, 2026

This page is general information, not advice about your specific situation, and it is not connected with or endorsed by the U.S. government or the federal Medicare program. Rules and figures change, so confirm current requirements with CMS, Social Security, or a licensed agent before you act. We do not offer every plan available in your area. Currently we represent 5 organizations which offer 300 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Can I keep my doctor with Medicare Advantage?

Sources

Related Questions

What is the difference between Medicare Advantage and Medigap?

When can I change my Medicare plan?

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