Medicare Plans
Medicare Advantage vs. Medicare Supplement in Austin, TX
Most Austin retirees end up choosing between the same two roads: a Medicare Advantage plan that bundles everything into one low-premium private plan, or a Medicare Supplement, also called Medigap, that sits behind Original Medicare and pays what Medicare leaves unpaid.
There's no universal right answer. It comes down to your doctors, your prescriptions, how much you travel outside Central Texas, and how much monthly cost you're willing to trade for predictability.
- Two different ways to cover the gaps in Original Medicare
- Which hospitals are in network is usually the deciding factor
- The premium is only half of what a plan costs you
- Free side-by-side comparison for Austin-area residents
See both paths priced for your doctors and drugs
Send us your doctors, your hospital and your prescriptions. A licensed agent prices a Medicare Advantage plan and a Medigap plus Part D setup from the carriers we represent, and calls you back during business hours with the full-year difference in dollars.
What to expect
Free review- A licensed agent calls you back during business hours, Mon-Fri, 8:30am-5:30pm CT
- Your doctors and prescriptions get checked before any plan is suggested
- No fee for our help, and your premium is the same either way
- No obligation to enroll, and no pressure if you'd rather stay put
Reviewed by the licensed Texas agents at Austin Senior Insurance. Last reviewed: October 2026. Office hours: Mon-Fri, 8:30am-5:30pm CT.
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Side by side
Where the two paths differ
| Compare | Medicare Supplement Medigap · pairs with Original Medicare | Medicare Advantage Part C · all-in-one private plan | Part D Drug Plan Prescriptions only · add-on |
|---|---|---|---|
| What it covers | Your share of Part A and Part B costs, including deductibles, copays and coinsurance. | Hospital, medical and usually drugs, bundled into one plan with one card. | Prescription medications only. Nothing medical. |
| Doctor networks | None. Any provider in the U.S. who accepts Medicare. | HMO or PPO network. Confirm your St. David's, Ascension Seton or Baylor Scott & White doctors are in it. | Pharmacy network only. Preferred pharmacies usually cost less. |
| Monthly premium | Highest of the three, plus your Part B premium. | Often $0, plus your Part B premium. | Low monthly premium, plus your Part B premium. |
| Costs when you use care | Little to nothing after the Part B deductible on Plan G. | Copays per visit and per service, capped by an annual out-of-pocket maximum. | Deductible and tiered copays based on the plan's drug list. |
| Prescription drugs | Not included. You add a separate Part D plan for that. | Included in most Central Texas plans. | This is the drug coverage. |
| Extras (dental, vision, hearing) | Not included. Buy standalone if you want them. | Commonly included, with allowances that vary a lot by plan. | Not included. |
| Health questions to enroll | None during your 6-month open enrollment; underwriting applies later. | None. Acceptance is guaranteed during a valid enrollment period. | None. |
| Best if you | Travel often, see specialists frequently, and want predictable bills. | Are settled with your local providers and want low premiums plus extras. | Chose Medigap or Original Medicare and need drug coverage. |
| Read more | Medicare Supplement details | Medicare Advantage details | Part D Drug Plan details |
Medicare Supplement
Medigap · pairs with Original Medicare
- What it covers
- Your share of Part A and Part B costs, including deductibles, copays and coinsurance.
- Doctor networks
- None. Any provider in the U.S. who accepts Medicare.
- Monthly premium
- Highest of the three, plus your Part B premium.
- Costs when you use care
- Little to nothing after the Part B deductible on Plan G.
- Prescription drugs
- Not included. You add a separate Part D plan for that.
- Extras (dental, vision, hearing)
- Not included. Buy standalone if you want them.
- Health questions to enroll
- None during your 6-month open enrollment; underwriting applies later.
- Best if you
- Travel often, see specialists frequently, and want predictable bills.
Medicare Advantage
Part C · all-in-one private plan
- What it covers
- Hospital, medical and usually drugs, bundled into one plan with one card.
- Doctor networks
- HMO or PPO network. Confirm your St. David's, Ascension Seton or Baylor Scott & White doctors are in it.
- Monthly premium
- Often $0, plus your Part B premium.
- Costs when you use care
- Copays per visit and per service, capped by an annual out-of-pocket maximum.
- Prescription drugs
- Included in most Central Texas plans.
- Extras (dental, vision, hearing)
- Commonly included, with allowances that vary a lot by plan.
- Health questions to enroll
- None. Acceptance is guaranteed during a valid enrollment period.
- Best if you
- Are settled with your local providers and want low premiums plus extras.
Part D Drug Plan
Prescriptions only · add-on
- What it covers
- Prescription medications only. Nothing medical.
- Doctor networks
- Pharmacy network only. Preferred pharmacies usually cost less.
- Monthly premium
- Low monthly premium, plus your Part B premium.
- Costs when you use care
- Deductible and tiered copays based on the plan's drug list.
- Prescription drugs
- This is the drug coverage.
- Extras (dental, vision, hearing)
- Not included.
- Health questions to enroll
- None.
- Best if you
- Chose Medigap or Original Medicare and need drug coverage.
Local networks
What this looks like at Austin hospitals
-
Medigap: no network to worry about
If a doctor accepts Original Medicare, your Medigap plan goes with you. That covers St. David's, Ascension Seton, Baylor Scott & White, and specialists anywhere in the country, no referrals needed. -
Advantage: the network is the plan
Austin Advantage plans vary on which hospital systems they contract with. Some lean toward St. David's hospitals, others toward Ascension Seton or Baylor Scott & White. Networks can change every January. -
Drug coverage works differently
Advantage plans usually fold Part D right in. With Medigap you buy a standalone Part D plan and can shop it separately every fall, often the cheaper route if you're on an expensive drug.
Across Travis, Williamson and Hays counties, the network question usually comes down to St. David's HealthCare, Ascension Seton and Baylor Scott & White. Anyone in cancer treatment should check where their oncologist practices too. Veterans who get care at VA clinics can use VA benefits alongside either path, but the VA does not bill Medicare, so think about where you'll get care outside the VA. See whether we cover your town on our service areas page.
Choose Advantage if
When a Medicare Advantage plan makes sense
- You want the lowest monthly premium, often $0 beyond Part B
- Your doctors and preferred hospital already sit inside the plan's Austin network
- Extras like dental, vision, hearing and a gym membership matter to you
- You're fine with copays as you use care, backed by an annual out-of-pocket cap
- You mostly stick to the Austin area for routine appointments
Choose Medigap if
When a Medicare Supplement makes sense
- You'd rather pay one predictable premium than copays at every visit
- You see several specialists, or split your year between Texas and another state
- You want to keep any doctor who accepts Medicare, with no referrals required
- You have ongoing treatment where per-visit copays would pile up quickly
- You're inside your 6-month Medigap open enrollment window and can sign up without health questions
The timing detail people trip over
You can join or change an Advantage plan each fall during Open Enrollment. Moving back to a Medigap plan later usually means answering health questions, and the insurer can decline you. Keep that one-way street in mind before you make your first choice.
Total cost
Compare the whole year, not the premium
A $0-premium Advantage plan isn't free. Add up realistic copays for your regular doctor visits, specialists, imaging and any planned procedure, then stack that total against a year of Medigap premiums plus a standalone drug plan. For a healthy 66-year-old in Pflugerville or South Austin, the Advantage math often wins. For someone managing a chronic condition with frequent specialist visits, Medigap often costs less across twelve months.
We run that math using your own drug list and doctors. Start with the Medicare checklist, or read the mistakes to avoid before you sign anything. For free, unbiased counseling on every plan in your county, Texas HICAP (Health Information, Counseling and Advocacy Program) is at 1-800-252-9240.
Questions
Advantage vs. Medigap questions from Austin seniors
Can I have Medicare Advantage and a Medigap plan at the same time?
Which one costs less in Austin?
Do I still pay the Part B premium with either choice?
Does Medigap include prescription drug coverage?
Can I switch from Advantage to Medigap later?
Still not sure which side fits you?
Bring your doctors and your prescriptions. We'll price both paths for a full year and show you the difference in dollars.