Medicare Advantage vs. Original Medicare Cost Calculator

The question of whether Medicare Advantage or Original Medicare plus a Medigap supplement is 'better' doesn't have a universal answer, and most attempts to give one collapse the moment you look at how differently the two paths distribute cost across a year.

Original Medicare with a Medigap supplement is a predictable-cost model: you pay a fixed premium every month — Part B plus Medigap plus a Part D drug plan — and in exchange, your out-of-pocket cost for Medicare-covered services in a given year is close to zero, regardless of whether that year turns out to be a light one or one with a major hospitalization. The tradeoff for that predictability is the premium itself, paid every month whether or not you use any healthcare that year.

Medicare Advantage flips the risk profile: premiums are frequently $0 (though not always), but the plan uses copays, coinsurance and deductibles up to an annual out-of-pocket maximum, meaning your actual cost for the year depends heavily on how much healthcare you actually use. A year with minimal doctor visits can be genuinely inexpensive under Medicare Advantage — cheaper than the equivalent Medigap premium would have cost, paid for coverage you didn't end up needing. A year with a hospital stay or a new expensive diagnosis can push a beneficiary toward that plan's full out-of-pocket maximum, which is frequently higher than a full year of Medigap premiums would have been.

This is exactly why 'Medicare Advantage is cheaper' and 'Medigap is cheaper' are both true and both false, depending entirely on which year you're looking at and whose health history you're modeling. Someone in excellent health with no regular prescriptions and no expected procedures is, on average, likely to spend less under Medicare Advantage's low-or-no premium structure. Someone managing a chronic condition with predictable ongoing costs, or simply someone who places a high value on cost certainty regardless of what the year brings, often comes out ahead — financially or at least in peace of mind — with Medigap's fixed, predictable premium.

The factor this calculator deliberately doesn't try to put a dollar value on, because it can't be reduced to one, is network access. Original Medicare combined with Medigap works with any provider in the country that accepts Medicare — no referrals, no network restrictions, full flexibility to see any specialist or use any hospital nationwide. Medicare Advantage plans, built on HMO or PPO network structures, restrict which providers are covered at the in-network rate, and that restriction is specific to each individual plan and county. For someone who splits time between two states, travels frequently, or has an established relationship with a specialist outside a prospective MA plan's network, that structural difference can matter more than any premium or out-of-pocket estimate — which is exactly why this calculator is built to inform the cost side of the decision, not to replace weighing the network question separately.