Two structurally different ways to get Medicare coverage — a bundled Medicare Advantage plan with an annual out-of-pocket cap, versus Original Medicare paired with Medigap and a separate Part D plan.
How it works
Medicare Advantage’s annual cost is its premium plus expected usage, capped at the plan’s maximum out-of-pocket. Original Medicare’s annual cost is the sum of Part B, Medigap, and Part D premiums — Medigap absorbs most additional cost-sharing beyond that.
What this does not include
This uses simplified premium and cost-sharing assumptions — actual Medicare Advantage plans vary widely in network restrictions, prior authorization requirements, and covered services, factors beyond the pure cost comparison shown here.
How to use this calculator
- Enter Medicare Advantage premium, max out-of-pocket, and expected usage, plus Part B, Medigap, and Part D premiums.
Frequently asked questions
Why does Medicare Advantage often have a $0 premium?
Medicare Advantage plans receive payments from Medicare to cover beneficiaries, allowing many plans to offer low or $0 premiums while still capping out-of-pocket costs — though network restrictions often apply.
Why would someone choose Original Medicare with Medigap instead?
Broader provider access (most doctors accepting Medicare, without network restrictions) and more predictable, often lower ongoing cost-sharing, in exchange for a higher combined monthly premium.
Can you switch between Medicare Advantage and Original Medicare?
Yes, generally during open enrollment periods — though switching back to Original Medicare with a new Medigap policy after being on Medicare Advantage can involve medical underwriting in many states.
