This Medicare Advantage vs Medigap cost calculator prices one year of each type of Medicare coverage side by side. One path is the original federal program plus Medicare Supplement Insurance (Medigap Plan G and Plan N are the choices) and a separate Part D plan. The other is a Medicare Advantage plan; Medicare Advantage plans bundle hospital, medical, and usually drug benefits. Enter your quotes and copays, and it runs both through a light year, a typical year, and a hard one.
You get each path’s total at each level of care, the fixed premiums owed before any doctor visit, the copay spending where the two tie, and the worst covered year. It doesn’t pick a winner; it shows where the lines cross so you can compare costs.
Medicare Advantage vs Medigap Cost Calculator
Compare one year of Original Medicare with Medigap Plan G or Plan N and a Part D plan against a Medicare Advantage plan, at low, medium, and high use of care.
Uses the 2026 CMS Part B premium ($202.90), Part B deductible ($283), and IRMAA rows, the CMS in-network out-of-pocket ceilings ($9,250 for 2026, $9,850 for 2027), the Part D drug cap ($2,100 for 2026, $2,400 for 2027), and the Plan N copays published on Medicare.gov. Use levels, supplement premium, and Advantage copays are examples; replace them with your quotes and your plan's Summary of Benefits. Services neither path covers (most dental, hearing, long-term care) are left out. This is an educational cost comparison, not insurance advice or a recommendation of either option.
The Yearly Bill at Low, Medium, and High Use
The three levels are examples we built, not national statistics. Each lists visits plus the Medicare-approved dollars for tests and procedures, which is what copays and coinsurance act on.
| Level | Care in the year | Supplement path (G) | Advantage path |
|---|---|---|---|
| Low | 3 office visits, $400 of lab work, $120 at the pharmacy | $5,052 | $2,858 |
| Medium | 10 office visits, 1 ER trip, $3,000 of tests, $900 at the pharmacy | $5,832 | $4,503 |
| High | 18 office visits, 1 ER trip, 5 hospital days, $40,000 of outpatient care, drugs at the cap | $7,032 | $13,953 |
Advantage costs $2,194 less in the light year and $1,329 less in the typical one. In the hard year its copays reach $10,430, the $9,250 limit stops them, and the supplement path wins by $6,921. Inputs are the defaults; the $150 supplement premium stands in for your quote. We checked every row by hand.
How Medigap Works Alongside Original Medicare
A policy that supplements Original Medicare pays most of the costs that Original Medicare leaves behind. Medigap plans are standardized by letter, so G from one insurer carries the same benefits as G from another; only the premium and service differ. (Massachusetts, Minnesota, and Wisconsin use their own standardized Medigap plans.)
- What Plan G covers: the hospital deductible ($1,736 per benefit period in 2026), 20% coinsurance on medical care, skilled nursing coinsurance, and Part B excess charges. You pay the $283 Part B deductible and little else for covered care.
- What Plan N adds: up to $20 for some office visits and up to $50 for an ER visit that doesn’t lead to an inpatient admission, per Medicare.gov. It skips excess charges, the up to 15% a doctor who doesn’t accept assignment may bill above the approved amount.
- High-deductible G: sold in some states; you pay the first $2,950 of covered costs in 2026.
G or N is mostly a premium trade: N is priced lower and the copays eat part of that. At $115 a month, N totals $4,692, $5,662, and $7,022 across the three levels, below G in all three.
Insurers set Medigap premiums three ways: community-rated (same for everyone), issue-age-rated (set by your age at purchase), or attained-age-rated (rising yearly). Medigap typically has no network; any doctor who takes Medicare works.
How Medicare Advantage Works: Copays, Networks, and the Yearly Cap
Medicare Advantage replaces the fee-for-service program as the way your Medicare benefits are paid. A private insurer approved by the Centers for Medicare & Medicaid Services must cover everything Parts A and B cover, and many Medicare Advantage plans include prescription drug coverage plus extras such as dental or vision. You still pay the standard Part B premium ($202.90 in 2026, up from $185.00 under 2025 Medicare rates).
You pay copays as you use care, up to a yearly out-of-pocket maximum (the MOOP) for covered hospital and medical services. CMS sets the ceiling by plan type:
| Plan year | Highest in-network limit | PPO in plus out of network |
|---|---|---|
| 2026 | $9,250 | $13,900 |
| 2027 | $9,850 | $14,800 |
Those come from CMS’s final bid review memos. Plans may set lower limits, and CMS gives insurers more cost-sharing room when they do. The figure that counts is the one in your plan’s Evidence of Coverage.
Two trade-offs never show up in dollars. Network restrictions: HMOs generally require in-network care except emergencies, and PPOs charge more out of network. Prior authorization: a plan may require approval before covering certain services, and a denial can leave you owing the full cost. The original program usually requires neither.
Drug Coverage and IRMAA Land on Both Sides
Both paths carry drug benefits with the same yearly cap on what you pay at the pharmacy: $2,100 in 2026 and $2,400 in 2027. The tool charges drug spending equally to both, so it never tips the result. What differs is formularies and pharmacy networks, which the Medicare Plan Finder checks.
Income surcharges don’t favor either side. The medical add-on applies to anyone enrolled in Medicare Part B, and the drug add-on follows Part D whether it comes from a stand-alone plan or an Advantage plan. At row 2 (above $137,000 single), both columns rise $2,884.80 a year and the gap stays put. Our IRMAA estimator finds your row.
Comparing Medigap vs Medicare Advantage Plans: Where the Costs Cross
With G, the supplement path is nearly fixed: once the deductible is met, you’ve paid your share, apart from services neither side covers, like most dental care. Medigap offers predictability; Advantage offers lower premiums. So when choosing between Medigap vs Medicare Advantage, ask how much Advantage cost-sharing it takes to erase the premium gap.
In the defaults that break-even is $2,329: $4,648.80 of supplement-side premiums, plus the $283 deductible, minus $2,602.80 of Advantage premiums. A year with more than $2,329 of Advantage out-of-pocket costs favors the supplement; less favors Advantage. Higher monthly premiums buy a lower ceiling: the worst covered year is $7,032 with G and $13,953 with Advantage.
- Compare Medigap quotes in your ZIP code and enter a real monthly premium.
- Compare Medicare Advantage plans by their Summary of Benefits: copays and the limit.
- Read the break-even against your last two years of care.
Health carries the most weight: monthly specialist visits and infusions put you near the high row, one checkup a year near the low one. Terms change yearly, so rerun it each fall.
Medigap Open Enrollment and Guaranteed Issue Rights
The one-time Medigap Open Enrollment Period lasts 6 months and starts the first month you have Part B and are 65 or older. During it, an insurer must sell you any policy it offers in your state, priced without regard to health. Afterward, in most states, companies can use medical underwriting and deny coverage based on health.
Federal guaranteed issue rights reopen the door in set cases: your Advantage plan leaves the program or stops serving your area, you move away, an employer or union plan that pays after Medicare ends, or an insurer goes bankrupt or misled you. You generally apply within 63 days after the old coverage ends. In those cases the federal list is Plans A, B, C, D, F, and G; N isn’t on it.
Trial rights are the exception. Join an Advantage plan when you’re first eligible for Medicare at 65, leave within 12 months, and you can buy any Medigap policy sold in your state. Drop a supplement to try Advantage for the first time, and you can get that policy back within the year if the company still sells it.
State Rules That Change the Timing
New York requires Medigap insurers to accept applications year-round with no health-based denials or pricing. Connecticut makes Medigap guaranteed issue at all times, with rates that can’t vary by age, gender, or health. California gives holders of a Medicare Supplement plan a 60-day window starting on their birthday to move to an equal or lesser plan without medical screening. Other states have similar rules; ask your State Health Insurance Assistance Program (SHIP).
Switching Between Medigap and Medicare Advantage Later
Moving to Advantage is easy: join during Open Enrollment (October 15 to December 7) for coverage on January 1. Going back is hard. You can leave an Advantage plan in that window or from January 1 to March 31 (one change), but without a guaranteed issue right or state rule, a supplement insurer can review your health and say no.
That one-way door is a cost no premium figure shows. A new Medicare enrollee who might want a supplement at 75 may want to weigh buying in the first 6 months. Late sign-up adds its own surcharge; see the late enrollment penalty tool. For a lifetime view, try the retirement healthcare cost estimator.
Frequently Asked Questions
How much more expensive is Medigap than Medicare Advantage?
In our example, $2,046 a year in fixed premiums. Total cost depends on how much care you use.
Can I have both?
No. Selling you a supplement while you’re in an Advantage plan is illegal, and a supplement can’t pay Advantage copays.
Which is the right plan?
The one whose worst year you can afford, whose network holds your doctors, and whose rules fit. Run the Medicare Advantage vs Medigap cost calculator above with real quotes to compare options, then confirm with a SHIP counselor.
Last reviewed September 2026 against the CMS 2026 premium fact sheet, the Medicare.gov Medigap benefits chart, and CMS’s final Part C limits for 2026 and 2027. The 2027 premium and deductible arrive in the fall. A cost comparison for education only, not insurance advice or a recommendation of either path.