In short
- You cannot use both at once. Medigap works only with Original Medicare, and you cannot use it to pay Medicare Advantage costs.
- The Nebraska Department of Insurance lists Plan G premiums at 65 from $135 to $766 a month (2026). The average Medicare Advantage premium is $14.14 a month for 2027.
- Lancaster County's 2027 Medicare Advantage in-network out-of-pocket limits range from $4,400 to $9,850, before drug costs.
- Nebraska has no birthday rule. After your 6-month Medigap window, companies may refuse you for health reasons.
- About 34% of Nebraskans on Medicare were in Medicare Advantage or other plans in June 2026.
Medicare Supplement (Medigap) vs Medicare Advantage at a glance
| Feature | Medicare Supplement (Medigap) | Medicare Advantage |
|---|---|---|
| How it works | Adds to Original Medicare and pays your share of approved costs | Replaces Original Medicare with a private plan |
| Doctors and hospitals | Any U.S. provider that accepts Medicare, no network | Plan network; PPOs cover out of network at a higher cost |
| Monthly plan premium in Nebraska | Plan G at age 65: $135 to $766 (2026, Nebraska Department of Insurance) | Average $14.14 for 2027; 97.69% of Nebraskans can get a $0-premium plan, and still pay the Part B premium |
| Part B premium | You pay it ($202.90 in 2026) | You pay it ($202.90 in 2026) |
| Most you pay for covered medical care | With Plan G, the $283 Part B deductible (2026) | In-network limits from $4,400 to $9,850 in Lancaster County (2027) |
| Prescription drugs | Not included; add a Part D plan (9 in Nebraska for 2027) | Usually included |
| Prior approval and referrals | Generally not needed in Original Medicare | Prior authorization for some services; HMOs usually require referrals |
| Dental, vision and hearing | Not covered; buy separately | Often some coverage, generally limited |
| Travel | Any Medicare provider in the U.S.; Plans G and N pay 80% of foreign emergencies | Emergency and urgent care anywhere; routine care depends on the network |
| Switching later | After the 6-month window, companies may refuse you for health reasons | Change plans each fall, October 15 to December 7 |
| Year-to-year changes | Benefits are standardized; premiums usually rise | Benefits, networks and premiums can change every January |
The short answer
Medigap fits people who want any doctor, travel often, or want predictable costs and can afford the premium, ideally bought during the 6-month open enrollment window. Medicare Advantage fits people who want a low premium and some extras, are comfortable with a network, and could pay the yearly out-of-pocket maximum in a bad year.
This is the biggest Medicare decision most people make, and the hardest to undo. Both paths cover the same Medicare-covered care. They differ in how you pay for it, which doctors you can see, and how easily you can change your mind later.
What is the difference between a Medicare Supplement and Medicare Advantage?
A Medicare Supplement, also called Medigap, sits on top of Original Medicare and pays most or all of what Medicare leaves you. Medicare Advantage, also called Part C, replaces Original Medicare with a private plan that has its own network, copays and yearly out-of-pocket limit.
With Medigap, you keep Original Medicare, see any provider in the country that accepts it, and add a separate Part D drug plan. With Medicare Advantage, you get Part A, Part B and usually drug coverage through one plan, often with some dental, vision or hearing benefits, but within a network and with prior authorization for some services.
You cannot have both at once. You cannot use a Medigap policy to pay Medicare Advantage copays or premiums.
How do the costs compare in a good year and a bad year?
Medicare Advantage usually costs less in a healthy year. Medigap usually costs less in a bad one. Here is the math for one 65-year-old in Lincoln, using the most recent figures available for each piece.
| Yearly cost | Medigap Plan G + Part D | Medicare Advantage with drugs |
|---|---|---|
| Part B premium ($202.90 a month, 2026) | $2,434.80 | $2,434.80 |
| Plan premium | About $2,460 (Medicare.gov's median low-end Plan G estimate, about $205 a month) plus a Part D premium | Often nothing beyond Part B: 16 of 22 Lancaster County plans with drugs have no plan premium for 2027 |
| Quiet year: a few office visits | $283 Part B deductible | Small copays |
| Bad year: surgery and a hospital stay | $283 Part B deductible | Up to the plan's in-network limit: $4,400 to $9,850 in Lancaster County for 2027 |
| Drug costs, either way | Up to $2,400 (2027 cap) | Up to $2,400 (2027 cap) |
Add it up for a bad year with heavy drug costs. Plan G comes to roughly $7,600 plus the Part D premium. Medicare Advantage comes to roughly $9,200 to $14,700, depending on the plan's limit. In a quiet year, the order flips, and Medicare Advantage can come out thousands ahead.
Plan availability, premiums, networks and benefits vary by county and change every year, so run the math with the actual plans in your county.
What does the Nebraska market look like for 2027?
Nebraska leans toward Original Medicare more than most of the country. CMS counted 398,932 Nebraskans on Medicare in 2026, and about 34% were in Medicare Advantage or other health plans in June 2026: 35% in Lancaster County, 45% in Douglas County and 39% in Hall County. KFF estimates 55% of eligible people nationally are in Medicare Advantage in 2026.
On the Medicare Advantage side, CMS counts 48 plans statewide for 2027, down from 50, and the average premium falls from $20.65 to $14.14. Several carriers are redrawing their maps. Medica leaves Lancaster, Douglas, Sarpy and five other eastern counties. UnitedHealthcare's AARP plans with drug coverage shrink to five eastern counties. Blue Cross and Blue Shield of Nebraska drops from 76 counties to 61. Devoted Health grows from 14 counties to 42, including Lancaster. Our 2027 Medicare Advantage update has the details.
On the Medigap side, the Nebraska Department of Insurance lists Plan G at age 65 from $135 to $766 a month in 2026, and says most Nebraska policies are attained-age rated, so premiums rise with age.
Why does timing matter so much in Nebraska?
Because the Medigap door is widest once. Your 6-month Medigap Open Enrollment Period starts the first month you have Part B and are 65 or older. During it, any company must sell you any Medigap policy it offers, regardless of health. Nebraska has no birthday rule. After the window, the Department of Insurance says, "companies may refuse coverage because of health reasons."
There are federal safety valves:
- Trial right. If you join Medicare Advantage when you first get Medicare at 65, you can return to Original Medicare within 12 months and buy any Medigap policy sold in Nebraska, no health questions.
- Plan leaves your area. If your Medicare Advantage plan stops serving your county and you go back to Original Medicare, you can buy certain plans without underwriting (A, B, D or G if you were new to Medicare in 2020 or later), applying no more than 63 days after coverage ends.
Who is a Medicare Supplement a better fit for?
Medigap fits people who value choice and predictability and can carry the premium.
- You want to see any doctor or hospital that takes Medicare, including specialists across health systems or across the state line.
- You winter out of state or travel often. See Medicare when you travel.
- You manage health conditions and want low costs when you use care.
- You are in your 6-month window and can afford the premium now and as it rises with age.
Choosing a plan letter is the next step: see Plan G vs Plan N.
Who is Medicare Advantage a better fit for?
Medicare Advantage fits people who want a low monthly cost and are comfortable with a network.
- Your doctors and hospitals are in the plan's network. Check Bryan Health, CHI Health or Nebraska Medicine by name; never assume.
- You want some dental, vision or hearing benefits in one plan.
- You could pay the yearly out-of-pocket limit from savings in a bad year.
- A Medigap premium would strain your monthly budget.
HMO or PPO is the next question. See HMO vs PPO.
What mistakes do people make choosing between them?
The biggest mistake is picking Medicare Advantage at 65 for the low premium without knowing it can be hard to get a Medigap policy later.
Other common mistakes:
- Comparing premiums only. Compare a quiet year and a worst-case year.
- Forgetting drug coverage with Medigap. Medigap does not cover prescriptions. Add a Part D plan or face a late penalty.
- Assuming the network includes your doctors. Check every provider, every year.
- Never reading the Annual Notice of Change. Medicare Advantage plans can change benefits, networks and premiums each January.
- Thinking the fall enrollment period covers Medigap. October 15 to December 7 is for Medicare Advantage and Part D. It gives no new Medigap rights.
Who can give you an unbiased read on both paths?
Medicare.gov's Plan Finder shows every Medicare Advantage and Part D plan in your ZIP code, and its Medigap tool shows estimated prices. You can call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week (TTY 1-877-486-2048). Nebraska SHIP (formerly SHIIP) gives unbiased counseling at 1-800-234-7119. See our page on SHIP and local help.
If you want both paths priced with your doctors, medications and budget, talk to me. My help costs you nothing.
Frequently asked questions
No. A Medigap policy only works with Original Medicare. You cannot use it to pay Medicare Advantage copays, deductibles or premiums, and Medicare says you cannot buy a Medigap policy while you are in a Medicare Advantage plan unless you are switching back to Original Medicare. You choose one path or the other.
You can leave Medicare Advantage during the fall enrollment period or the January to March window, but getting a Medigap policy is not guaranteed. Nebraska has no birthday rule, and outside your 6-month Medigap Open Enrollment Period or a guaranteed issue right, companies may refuse coverage for health reasons. Guaranteed issue rights include your plan leaving your area and the first-year trial right.
If you join a Medicare Advantage plan when you first get Medicare at 65, federal rules let you drop it within the first 12 months and return to Original Medicare. You then have a guaranteed right to buy any Medigap policy sold in your state, with no health questions. A similar right applies if you dropped a Medigap policy to try Medicare Advantage for the first time.
You will get a notice, and you can choose another Medicare Advantage plan or return to Original Medicare. If you return to Original Medicare, you have a federal guaranteed issue right to buy certain Medigap plans: A, B, D or G, plus C or F if you were eligible for Medicare before 2020. Apply no more than 63 days after your coverage ends. Several carriers are shrinking their Nebraska service areas for 2027.
Usually in a healthy year, not always in a bad one. Medicare Advantage premiums are low, and many plans have no plan premium beyond Part B, but you pay copays up to the plan's yearly limit. A Medigap Plan G costs more each month but leaves you very little to pay when you need care. Compare both using a quiet year and a worst-case year.
Many include some dental, vision or hearing benefits, but they are generally limited, and they vary by plan, county and year. Read the dollar limits and what is covered before you count on them. With a Medicare Supplement, you would buy dental and vision separately, since neither Original Medicare nor Medigap covers routine dental or vision care.
Sources
- Medicare.gov: Medicare & You 2027 (CMS Product No. 10050) (opens in a new tab)
- Medicare.gov: Choosing a Medigap Policy (CMS Product No. 02110, March 2026) (opens in a new tab)
- Nebraska Department of Insurance: Medicare Supplement Fact Sheet 2026 (opens in a new tab)
- CMS: Medicare Open Enrollment in Nebraska, 2027 state fact sheets (opens in a new tab)
- CMS: CY 2027 Medicare Advantage and Part D landscape files (opens in a new tab)
- KFF: Medicare Advantage in 2026, enrollment update and key trends (opens in a new tab)
- Medicare.gov: Find a Medigap policy (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
