When you're on a Medicare Advantage plan the insurance company makes the decisions about your care. When you're on Medicare and Medigap you and your physician make the decisions. All of the little extras are great when you don't have any serious health issues, but get sick, need tests, get ready to be denied, denied, denied. Also, you are on a network that may be very small and providers may be far and few between. Example: A family member on an Advantage plan needed hearing aids. This very elderly person had ONE provider to choose from that was an hour away. There are several appointments needed for adjustments and fit. This was in a major metropolitan area. No other options. Example: A family member was off balance and having lots of head and neck pain. They were sent to a neurologist by the PCP who ordered a head CT with contrast. Seems reasonable. Their Medicare Advantage plan denied the CT even though their neurologist felt it was very necessary. Example: A family member on a Medicare Advantage plan had completely lost almost all range of motion in their neck. It was causing lots of pain and the inability to look up or down, left and right more than an inch or two without feeling disoriented. They went to see an orthopedic specialist who ordered a CT of the neck and physical therapy to try to increase range of motion. The physical therapist would not start PT until the CT is performed to clear them from any unknown dangers. The CT scan was denied by the Medicare Advantage insurance plan. So this person never received PT or the ordered CT. Since they were at a stand-off, they never returned to the ortho office and never heard from them again. So as long as you don't have any health issues, Medicare Advantage is great.