Understanding Medigap and Medicare Advantage Basics
Medigap supplements Original Medicare (Parts A and B) by covering gaps like deductibles and coinsurance, while Medicare Advantage replaces Original Medicare with private plans that often bundle Part D drugs and extras. You must enroll in Original Medicare to buy Medigap, but Medicare Advantage is an all-in-one alternative.
In New Braunfels, TX, these plans impact access to trusted providers. Medigap lets you visit any Medicare-accepting doctor nationwide, including specialists at Christus Santa Rosa without referrals. Medicare Advantage typically restricts you to plan networks, which may or may not include Christus Santa Rosa—check specific 2026 plans.
Key Differences Between Medigap and Medicare Advantage in 2026
Cost Structure
Medigap requires a monthly premium on top of Medicare Part B ($202.90/month in 2026, plus the Part B deductible of $283), but offers predictable costs—no copays or coinsurance for covered services. Popular plans like G or N cover the 20% Part B coinsurance after the deductible.
Medicare Advantage often has $0 premiums beyond Part B, but features copays, coinsurance, and an out-of-pocket maximum of $9,250 for in-network services in 2026. Costs vary by usage, with many plans including Part D drugs.
Provider Networks and Flexibility
Medigap provides unlimited access to any U.S. provider accepting Medicare, ideal for New Braunfels seniors traveling or switching doctors like those at Christus Santa Rosa. No networks or referrals needed.
Medicare Advantage uses HMO or PPO networks; HMOs require referrals and limit out-of-network care, while PPOs offer more flexibility at higher costs. In New Braunfels, confirm if your Christus Santa Rosa providers are in-network, as plans change yearly.
2026 Cost Comparisons for New Braunfels Seniors
In 2026, the Medicare Part B deductible rises to $283, which Medigap Plans C, D, F, G, or N may cover fully or partially. Plan K has an $8,000 out-of-pocket limit, Plan L $4,000—after which it pays 100%.
Medigap premiums in Texas average $150–$300/month for Plan G, depending on age and insurer, offering no surprise bills beyond premiums. Medicare Advantage keeps premiums low but expect $20–$50 doctor copays, $100–$300 ER visits, and drug copays until hitting the $9,250 cap.
Pros and Cons of Medigap
Pros
- Nationwide freedom to choose providers like Christus Santa Rosa specialists without referrals.
- Predictable costs: Pay premium and Part B, then little out-of-pocket.
- Stable benefits; great for chronic conditions or travel.
Cons
- Higher monthly premiums; no built-in extras like dental.
- Separate Part D needed for prescriptions.
Pros and Cons of Medicare Advantage
Pros
- Often $0 premium plus extras (dental, vision, gym memberships).
- Out-of-pocket cap ($9,250 in 2026) protects heavy users.
- Includes Part D; one card simplifies care.
Cons
- Network limits—verify Christus Santa Rosa inclusion to avoid out-of-network costs.
- Variable copays; annual changes via ANOC.
Which is Right for You in New Braunfels, TX?
Choose Medigap if you value provider choice (e.g., Christus Santa Rosa access), predictability, or have ongoing health needs. Opt for Medicare Advantage if you want low premiums, extras, and stay in-network.
Call to Action: Get Personalized Help Today
Don’t navigate 2026 Medicare alone—Turning 65 Solutions specializes in Medigap vs. Medicare Advantage for New Braunfels seniors. Call 830-217-6711 now for a free consultation, rate comparisons, and enrollment help ensuring Christus Santa Rosa coverage. Secure your health and wallet before changes hit!