Medicare vs Medicare Advantage Calculator

Compare Original Medicare (Parts A+B) with Medicare Advantage plans. Factor in premiums, copays, drug coverage, and total annual costs.

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Built by Abiot Y. Derbie, PhD — Postdoctoral Research Fellow. Quantitative researcher specializing in statistical modeling and data-driven decision systems.

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Advanced Medicare Comparison Analysis 2026 CMS

Part B 2026: $202.90/mo Part B deductible: $283 Part A deductible: $1,736 MA OOP cap: $9,350 in-network Part D OOP cap: $2,000 NEW CMS · IRMAA · CY2026
PERSONALIZED FOR YOU

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The Core Trade-Off — Original Medicare + Medigap vs Medicare Advantage

Once you turn 65, you face a fork in the road. Original Medicare + Medigap gives you maximum provider choice, predictable costs, and works anywhere — but costs more in monthly premiums. Medicare Advantage (Part C) offers low or zero premiums and extra benefits like dental and vision, but limits you to network providers. The right choice depends on your health status, finances, and travel needs.

FeatureOriginal Medicare + Medigap Plan GMedicare Advantage (HMO/PPO)
Part B premium 2026$202.90/mo (everyone pays)$202.90/mo (you still pay this)
Plan premium$120-$300/mo Medigap (Plan G avg ~$170)$0-$80/mo (many $0)
Part D drug premium$30-$100/mo (separate)Often included ($0-$40 add-on)
Provider networkAny provider that accepts MedicareHMO: in-network only. PPO: in-network preferred
Travel coverageAnywhere in US (some Medigap = international)Limited to plan service area
Annual out-of-pocket max~$226 deductible (Plan G covers rest)$9,350 in-network (2026 federal cap)
Referrals required?NoHMO: yes. PPO: usually no
Prior authorization?RareCommon — can delay or deny care
Extra benefits (dental/vision/hearing/gym)NOT included (buy separately)Often included
Switching back if you don't like itAnnual Open Enrollment Oct 15-Dec 7
The "switching trap" most retirees don't know about: If you start on Medicare Advantage and try to switch back to Original Medicare + Medigap later, insurers can deny you Medigap coverage based on health (medical underwriting) in most states. Only your initial 6-month Medigap Open Enrollment Period at age 65 guarantees you can buy Medigap regardless of pre-existing conditions. Choose carefully at 65 — switching back may not be possible. Exceptions: CA, MA, MO, NY, OR, WA, and a few others have annual or birthday-month protections.

2026 premiums per CMS final notice (Nov 14, 2025). Medigap state-specific guaranteed-issue protections per Medicare.gov.

IRMAA — The Income Surcharge That Catches High Earners

IRMAA (Income-Related Monthly Adjustment Amount) is a Medicare surcharge based on your income from 2 years prior. For 2026, it's based on your 2024 tax return. If your 2024 MAGI exceeded $109K (single) or $218K (joint), expect a Part B premium increase of $81 to $487 per month per person — up to $6,936/year for high-income couples.

2024 MAGI Single / Joint2026 Part B Premium (per person)2026 Part D Surcharge
≤ $109K / ≤ $218K$202.90 (standard)$0
$109K-$137K / $218K-$274K$284.10 (+$81.20)+$14.50/mo
$137K-$171K / $274K-$342K$405.80 (+$202.90)+$37.50/mo
$171K-$205K / $342K-$410K$527.50 (+$324.60)+$60.50/mo
$205K-$500K / $410K-$750K$649.20 (+$446.30)+$83.40/mo
≥ $500K / ≥ $750K$689.90 (+$487.00)+$91.00/mo
The "cliff" effect: Cross a bracket by just $1 of MAGI and your annual surcharge can jump $1,000+. Plan Roth conversions and capital gains carefully in years 63-64 (before Medicare) and during retirement to manage MAGI. A $95K Roth conversion that pushes you $3K over a tier can cost $4,752/year in extra premiums for 1 year of conversion benefit.

SSA-44 — The IRMAA appeal most retirees miss

If a "life-changing event" caused your income to drop since 2024 — retirement, death of spouse, divorce, or work reduction — file Form SSA-44 to use more recent income. The approval rate for legitimate appeals is high, yet many retirees never file because they don't know it exists. If you retired in 2025 and IRMAA based on 2024 wages is hitting you in 2026, an SSA-44 with 2025 income documentation can eliminate or reduce the surcharge.

2026 IRMAA tiers per CMS. SSA-44 appeal form available at SSA.gov. MAGI calculation per IRC §1395r(i)(4): AGI + tax-exempt interest + excluded foreign earned income.

Medigap Plan Letters Decoded — Plan G vs Plan N vs High-Deductible G

Medigap plans are standardized by federal law into letters (A, B, C, D, F, G, K, L, M, N). Plan G is the most popular comprehensive plan for new Medicare enrollees in 2026 — it covers everything except the small Part B deductible. Plan F (which covers everything) is no longer available to new enrollees as of 2020.

Plan2026 Premium (avg, age 65)What You Still PayBest For
Plan G (most popular)$130-$220/mo$283 Part B deductible/yrPredictable costs, comprehensive coverage
Plan N$100-$170/mo$283 deductible + $20 office copay + $50 ER copayLower premium, accept small copays
High-Deductible Plan G$30-$60/moUp to $2,870 (2026) before benefits startHealthy retirees, "catastrophic-only" coverage
Plan K$60-$100/mo50% cost-share until $7,220 OOP capCost-conscious, willing to risk OOP
Plan L$80-$130/mo25% cost-share until $3,610 OOP capMiddle-ground OOP coverage
Plan F$160-$260/mo$0 — covers everythingPre-2020 enrollees only (closed to new)
Plan G vs Plan N — the modest cost-share question:
  • Plan G: ~$50/mo more in premium, but no copays at doctor visits
  • Plan N: ~$50/mo less premium, but $20 per office visit and $50 per ER visit
  • Math: If you visit doctor 30+ times/year, Plan G saves money. Under 25 visits/year, Plan N typically saves money.
  • Plan N caveat: Doesn't cover Part B "excess charges" — providers who don't accept Medicare assignment can charge up to 15% more. In states like NY, MA, MN, PA, and a few others, excess charges are banned anyway.

High-Deductible Plan G — the underrated option

High-Deductible G charges roughly $35-50/month — among the lowest premium Medigap options. You pay up to $2,870 in 2026 before Plan G benefits kick in. Effectively a "catastrophic only" Medigap: works well if you're healthy and want guaranteed-renewable coverage at low cost, with protection against major medical events. Combine with a $0 MA-style philosophy (lower premiums, accept some risk) but keep the freedom of Original Medicare provider choice.

Plan letters standardized per Medicare Improvement Patient and Provider Act of 2008 (MIPPA). Plan F closed to new enrollees as of Jan 1, 2020 per MACRA §401. Premium ranges vary significantly by state, age, gender, smoker status, and underwriting; always quote 5+ carriers.

Medicare Advantage — The "Free" Plans That Aren't Always Free

Medicare Advantage plans advertise "$0 premium" — and roughly 60% of MA plans do have $0 plan premium. But that doesn't mean Medicare is free. You still pay Part B ($202.90/mo in 2026) plus IRMAA if applicable. And the "free" plans rely on copays, coinsurance, and prior authorizations to control costs that Original Medicare + Medigap would simply pay outright.

"Hidden" MA CostWhat It Looks Like in PracticeAnnual Impact (typical)
Network restrictionsSpecialist out-of-network = full cost or denied$0-$10K+ if you need specific specialist
Prior authorization15% of MA prior auths denied initially (KFF 2024 study)Care delays, sometimes weeks-to-months
Copays per service$10-50 PCP, $40-80 specialist, $200-500 hospital/day$1,000-$5,000/year for active users
Coinsurance for major care20% of Medicare-approved amount (chemo, cardiac care, etc.)Up to MA OOP max of $9,350 in-network
Annual OOP max$9,350 in-network (2026 federal cap)Up to this if you have a serious illness year
Part D under "$0 plans"Often has formulary restrictions, tier pricing$200-$2,000/year depending on drugs
The "Healthy 65 → Sick 75" trap: When you're healthy at 65, MA's $0 premium looks great. When you're sick at 75 with cancer, heart disease, or stroke, MA's network and prior-authorization restrictions can deny you the specialists, treatments, or facilities you need. Surveys show MA enrollees 3-4× more likely to encounter denied care than Original Medicare enrollees. By the time you realize you want Original Medicare + Medigap, medical underwriting often blocks you from getting Medigap.

When Medicare Advantage is genuinely the better choice

  • Healthy retirees with limited budget — saves $150-$250/mo on premiums; OOP max protects against worst case
  • Strong local network — if your trusted providers are all in the MA network
  • Want "all-in-one" simplicity — one card, one bill, includes Part D and often dental/vision
  • Subsidized through Medicaid (Dual-Eligible Special Needs Plans) — these MA plans are often free or near-free for low-income retirees
  • Limited geographic mobility — if you stay in your service area year-round

MA prior authorization data per KFF 2024 analysis of CMS data. 2026 MA OOP cap per CMS final rule. ~52% of Medicare beneficiaries chose MA in 2025 per CMS enrollment data.

Decision Framework — Which One Fits Your Situation

No universal answer. The right Medicare path depends on your health, finances, providers, and travel patterns. Here's a structured framework based on your top 2-3 priorities.

Choose Original + Medigap if...

You travel extensively (snowbirds, cross-country family). You have specialists at major academic centers (Mayo, Cleveland Clinic, MD Anderson). You expect significant healthcare needs (chronic conditions, family longevity, current diagnosis). You can afford $150-$250/mo more in premiums. You want zero prior-authorization friction.

Choose Medicare Advantage if... $

You're healthy with no chronic conditions and want to minimize current spending. Your local doctors are in the MA network. You stay in one geographic area year-round. You value extra benefits (dental/vision/hearing/gym/transportation/groceries). You're on Medicaid or qualify for Special Needs Plan (D-SNP/C-SNP).

Consider High-Deductible G if... $$

You want lower premium ($30-50/mo) AND keep Original Medicare's flexibility. You're healthy and willing to risk up to $2,870/year. You want guaranteed-renewable Medigap protection in case health changes.

The "delay enrollment" rookie mistake: If you don't enroll in Part B during your Initial Enrollment Period (3 months before 65, the month of, 3 months after), you face a 10% Part B premium penalty for life per 12-month delay. Same with Part D (1% per month delay). Exception: if you have employer coverage at a company with 20+ employees, you can delay penalty-free. Always confirm enrollment timing with your specific situation.

The annual review you must do every fall

Medicare Open Enrollment runs October 15 - December 7 each year. During this window, you can switch between Original Medicare ↔ MA, change MA plans, change Part D plans, or add/drop drug coverage. Plans change every year — formularies update, providers leave networks, premiums shift. Reviewing your plan each fall is the single most important Medicare task. The 5-Star Special Enrollment Period also lets you switch to a 5-star MA or Part D plan once per year between Dec 8 - Nov 30.

Late enrollment penalties per Medicare Modernization Act 2003. SEP rules per CFR §422.62. Open Enrollment Period per Medicare.gov. Medicare Advantage Open Enrollment Period (MAOEP) Jan 1 - Mar 31 also allows MA-to-MA switching.

Things to Know

Essential concepts for understanding your results

Original vs Advantage
What is the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A+B): government-run, accepted by 99% of providers, no network restrictions. You pay 20% coinsurance with no out-of-pocket maximum (unless you buy supplemental Medigap). Medicare Advantage (Part C): private insurance replacing Parts A+B. Often includes dental, vision, hearing, and drug coverage. Lower out-of-pocket costs but restricted to plan networks. Advantage plans have out-of-pocket maximums ($3,000-7,500/year) that Original Medicare lacks.

Cost Comparison
Which option costs less?

Advantage plans often have $0 premiums beyond the standard Part B premium ($174.70/month in 2026). Original Medicare + Medigap supplement costs $200-400/month additional. However, Advantage plans have higher per-service costs (copays, coinsurance) while Medigap covers most or all cost-sharing. For healthy seniors using few services: Advantage is cheaper. For those with chronic conditions needing frequent specialist visits: Original + Medigap provides more predictable costs and broader provider choice.

Switching
Can you switch between Original and Advantage?

You can switch during the Annual Enrollment Period (Oct 15 - Dec 7) each year. Critical warning: if you switch from Original Medicare back to an Advantage plan after age 65, you may face medical underwriting for Medigap policies if you later want to switch back. Some states guarantee Medigap enrollment regardless, but most do not. This means switching to Advantage and then back to Original could leave you unable to get affordable supplemental coverage — a trap many seniors do not discover until it is too late.

Medicare vs Medicare Advantage Calculator: Compare Your Options

Choosing between Original Medicare (Parts A+B) with a Medigap supplement and Medicare Advantage (Part C) is one of the most important healthcare decisions for retirees. This calculator compares total annual costs, coverage differences, and out-of-pocket risk for each option based on your health status and usage patterns.

Enter your age, health status, prescription needs, and preferred providers above to see a side-by-side comparison of costs and coverage.

Original Medicare + Medigap vs Medicare Advantage

FeatureOriginal Medicare + MedigapMedicare Advantage (Part C)
Monthly premiumPart B ($185) + Medigap ($120-$300) + Part D ($30-$80) = $335-$565/moPart B ($185) + MA plan ($0-$150) = $185-$335/mo
Doctor choiceAny doctor accepting Medicare (93% of physicians)Network only (HMO) or higher cost out-of-network (PPO)
Out-of-pocket maximumNone (Medigap G covers most costs)$3,000-$8,300/year (capped by plan)
Referral needed for specialistsNoOften (HMO plans)
Extra benefitsNoneDental, vision, hearing, gym, OTC allowance
Prescription drugsSeparate Part D plan requiredUsually included
Works nationwideYesUsually local network only
Best forFrequent travelers, multiple specialists, high healthcare usersHealthy retirees, budget-conscious, value extra benefits

According to KFF, 54% of Medicare beneficiaries are now enrolled in Medicare Advantage (up from 33% in 2015). However, Original Medicare + Medigap provides more predictable costs for high-use patients because Medigap Plan G covers nearly all out-of-pocket costs after a $257 annual Part B deductible.

Total Annual Cost Comparison

Healthy retiree (few doctor visits, 2-3 prescriptions):

Original Medicare + Medigap G: $4,020-$6,780/year. Medicare Advantage ($0 premium plan): $2,220-$3,500/year. MA saves $1,500-$3,300/year for healthy users.

High-use retiree (specialists, procedures, 5+ prescriptions):

Original + Medigap G: $4,020-$6,780/year (Medigap covers most extra costs). Medicare Advantage: $2,220 + OOP costs up to $5,000-$8,300 = $7,220-$10,500/year. Original Medicare saves $1,000-$4,000/year for high-use patients because Medigap covers what MA charges as copays/coinsurance.

The crossover point: if your annual out-of-pocket medical costs would exceed $3,000-$4,000 under MA, Original Medicare + Medigap is cheaper despite higher premiums. Below $2,000 in OOP costs: MA wins on total cost.

Frequently Asked Questions

Is Medicare Advantage better than Original Medicare?
For healthy retirees who stay local: MA saves $1,500-$3,300/year with extra benefits (dental, vision, gym). For retirees with chronic conditions, frequent specialists, or travel: Original Medicare + Medigap provides more predictable costs and nationwide coverage. The best choice depends on your health, location, and how much healthcare you expect to use.
How much does Medicare cost per month?
Part B standard premium: $185/month (2026). Medigap Plan G: $120-$300/month depending on state and age. Part D: $30-$80/month. Total Original Medicare: $335-$565/month. Medicare Advantage: $185 (Part B only, many MA plans have $0 additional premium) to $335/month with a premium MA plan. Higher-income retirees pay IRMAA surcharges of $74-$409/month extra on Part B.
Can I switch between Medicare and Medicare Advantage?
Yes — during the Annual Enrollment Period (Oct 15 - Dec 7) you can switch from MA to Original Medicare or vice versa. However, switching from MA back to Original Medicare does NOT guarantee you can purchase a Medigap policy without medical underwriting (except in some states with guaranteed-issue protections). This is critical: if you start with Original + Medigap and switch to MA, returning to Medigap later may be impossible or very expensive if you have health conditions.
Does Medicare Advantage cover dental and vision?
Most MA plans include basic dental (cleanings, X-rays, some fillings), vision (annual exam, eyeglass allowance), and hearing (annual exam, hearing aid discount). Original Medicare covers none of these. The value of MA dental/vision benefits: $500-$1,500/year depending on usage. This is a significant advantage if you would otherwise pay out-of-pocket for dental and vision care.
What is Medigap Plan G?
The most comprehensive Medigap plan available to new enrollees (Plan F is closed to those eligible after 2020). Plan G covers: Part A deductible, Part B excess charges, skilled nursing coinsurance, and 80% of foreign travel emergency. After paying the Part B deductible ($257/year in 2026), Plan G covers virtually all remaining costs. Monthly premiums: $120-$300 depending on state, age, and carrier. Best enrolled during your Medigap Open Enrollment (6 months starting at age 65 + Part B) — guaranteed issue, no medical underwriting.
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