Compare Medicare Advantage (Part C) with Original Medicare plus Medigap to find which coverage approach gives you the best value.
Medicare beneficiaries face a fundamental choice: Original Medicare (Parts A & B) with a Medigap supplement, or Medicare Advantage (Part C). Each approach has different cost structures, provider networks, and risk profiles.
Original Medicare + Medigap offers unlimited provider choice and predictable costs (high premium, minimal OOP). Medicare Advantage offers lower premiums (often $0) but uses copays, coinsurance, networks, and a maximum out-of-pocket limit. Which is cheaper depends on your healthcare usage.
This calculator compares annual costs for both approaches based on your expected healthcare utilization. These are educational estimates only, not actual plan quotes — Medicare Advantage plans vary greatly by zip code. Whether you are a beginner or experienced professional, this free online tool provides instant, reliable results without manual computation. By automating the calculation, you save time and reduce the risk of costly errors in your planning and decision-making process. This tool handles all the complex arithmetic so you can focus on interpreting results and making informed decisions based on accurate data.
This is one of the most consequential healthcare decisions for seniors. The wrong choice can cost thousands per year. This calculator provides a data-driven comparison to guide your enrollment decision. Having a precise figure at your fingertips empowers better planning and more confident decisions. Manual calculations are error-prone and time-consuming; this tool delivers verified results in seconds so you can focus on strategy.
Medicare Advantage Cost = MA Premium + (PCP Copay × Visits) + (Specialist Copay × Visits) + (Hospital Copay × Days), capped at MOOP Original Medicare + Medigap Cost = Part B Premium + Medigap Premium (× 12) Difference = MA Cost − OM+Medigap Cost
Result: MA: $220 | OM+Medigap: $4,320 | MA saves $4,100
Medicare Advantage: $0 premium + ($10 × 6 PCP) + ($40 × 4 specialist) = $220. Original Medicare + Medigap: ($185 + $175) × 12 = $4,320. MA saves $4,100 in a low-usage year with no hospitalization.
Medicare Advantage is essentially a bet: you trade low premiums for the risk of high costs if you get sick. In healthy years, MA saves thousands. In a year with hospitalization or serious illness, you could pay $3,000–$8,000 in copays. Medigap eliminates this variability but costs $2,000–$3,000/year in premiums regardless of usage.
MA networks restrict your choice of doctors and hospitals. If your preferred providers are in-network, this may not matter. But if you develop a complex condition requiring specialized care, narrow networks can limit options. Original Medicare offers complete provider choice nationwide.
Some beneficiaries start with Medicare Advantage while healthy, save the premium difference, then switch to Original Medicare + Medigap if health declines. This strategy works IF you can pass medical underwriting for Medigap later. The risk is being denied Medigap when you need it most.
Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers. It bundles Parts A, B, and usually D into one plan, often with additional benefits (dental, vision, hearing, gym). In exchange, you use a provider network and pay copays/coinsurance with a maximum out-of-pocket (MOOP) limit.
MA plans receive capitated payments from Medicare for each enrollee. In competitive markets, insurers use this revenue to offer $0 premium plans with extra benefits to attract members. You still pay your Part B premium. Low-premium doesn't mean low-cost — copays and coinsurance apply when you use services.
Maximum Out-of-Pocket (MOOP) is the most you'll pay for covered services in a year under Medicare Advantage. Once reached, the plan pays 100%. MOOPs range from $3,000 to $8,300 in-network. This is the worst-case scenario for MA costs. Original Medicare with Medigap essentially has a MOOP near $0.
Yes, during the Annual Enrollment Period (Oct 15 – Dec 7) or the MA Open Enrollment Period (Jan 1 – Mar 31). However, if you want Medigap, you generally need to pass medical underwriting after your initial enrollment period. Some states have guaranteed-issue protections.
Original Medicare + Medigap is much better for travelers. Original Medicare works with any doctor/hospital nationwide that accepts Medicare (over 97% do). Most MA plans only cover care in their network area. Some PPO-type MA plans offer out-of-area coverage but with higher costs.
Many MA plans include dental, vision, hearing, and fitness benefits not covered by Original Medicare. These extras are a genuine advantage. However, the dental/vision benefits are often limited (e.g., $1,000–2,000 dental allowance). Assess whether the extras offset the network and cost-sharing trade-offs.