Medigap vs Advantage Calculator
Both routes, and the care you expect
Your result will appear here
Fill in the fields and this updates as you type.
Know what this estimate is based on
- Jurisdiction
- United States — insurance is regulated state by state, so the rules behind a premium are your state's, not a federal schedule
- Rules and time period
- Premiums, limits and deductibles are the figures you enter. Health plan cost-sharing caps, Medicare amounts and state filings all reset annually.
- Scope and limitations
- Educational estimate only. Rates, required coverages and available discounts differ by where you live. Your premium is set by an insurer's own underwriting — driving record, claims history, credit-based insurance score where permitted, the property itself — and only a quote is binding. What a policy pays depends on its exclusions and limits, not on this estimate.
- Source links checked
- Sep 19, 2026
Built and regression-tested by Smart Tools Lab. It has not been individually reviewed by a licensed financial, tax, or legal professional.
How to use
- 01
Enter the monthly premium quoted for the Medigap policy you are considering and the monthly premium of a standalone Part D drug plan, because a Medigap policy never includes drug coverage and you need both. Medigap premiums vary enormously by state, age and insurer for identical coverage, since the benefits in each lettered plan are standardized by law but the price is not.
- 02
Enter the Medicare Advantage plan's monthly premium — often $0, which is the default here — and its out-of-pocket maximum. That maximum is the figure that decides what a bad year costs on the Advantage side, and every Advantage plan must publish one. There is no equivalent on the Medigap side because a Plan G policy leaves you almost nothing to pay.
- 03
Enter the Medicare-covered care you expect over the year, measured as the total the providers bill rather than your share of it. This is the input the comparison turns on, so it is worth running the page two or three times across a range rather than trusting a single guess.
- 04
Open Advanced options to check the statutory figures and your Advantage cost-sharing share. The Part B premium of $202.90 and the Part B deductible of $283 are the CMS 2026 amounts and apply to both routes; the coinsurance share stands in for the copays an Advantage plan charges, which vary by service in a way one number cannot capture.
- 05
Read the two annual totals, then read the two worst-year figures beneath them. The first pair answers which route is cheaper at the care you named. The second pair is the more important comparison, because the real difference between these products is not the average year — it is how much the worst year can cost you.
Formula
The Medigap route costs (the Medigap premium + the Part B premium + the Part D premium) × 12, plus the smaller of the Part B deductible and the care you expect. Plan G covers everything else Original Medicare leaves, so the deductible is the whole of the cost sharing and the total stops rising once care exceeds $283. The Advantage route costs (the Advantage premium + the Part B premium) × 12, plus your share of the care — the care multiplied by your cost-sharing percentage, capped at the plan's out-of-pocket maximum. The comparison is the difference between those two totals. The worst year on Medigap is the premiums plus the full Part B deductible, reached at any care above $283. The worst year on Advantage is the premiums plus the full out-of-pocket maximum, reached once care times your share exceeds it. Because the Medigap total is nearly flat and the Advantage total slopes upward until it caps, the two lines cross once, and that crossing is the level of care at which the more expensive premium starts paying for itself.
Example
Someone turning 65 is quoted $165 a month for a Plan G Medigap policy and $40 a month for a standalone Part D plan, against a $0-premium Advantage plan with a $5,500 out-of-pocket maximum and roughly a 20% share of costs. Both routes carry the 2026 Part B premium of $202.90. Expecting $12,000 of Medicare-covered care, the Medigap route costs $5,178 for the year — $4,895 of premiums plus the $283 Part B deductible — and the Advantage route costs $4,835, being $2,435 of Part B premiums plus $2,400 of cost sharing. Advantage is $343 cheaper. But the worst-year figures tell the other half of the story: Medigap cannot exceed $5,178 however ill you get, while Advantage tops out at $7,935. Run the same inputs at $40,000 of care and Medigap is $2,757 cheaper; run them at $2,000 of care and Advantage is $2,343 cheaper. The turn happens between $13,500 and $14,000 of care, where the two totals come within $50 of each other.
Definitions
- Medigap premium
- The monthly cost of a Medicare Supplement policy. Benefits within each lettered plan are standardized by federal law, so two Plan G policies pay identically and the premium is the only difference.
- Part D drug plan
- A standalone prescription drug plan, needed alongside Medigap because no Medigap policy covers drugs. Most Advantage plans include drug coverage instead.
- Advantage plan premium
- What the Medicare Advantage plan charges on top of Part B. Frequently $0, which does not mean the coverage is free — the Part B premium is still due.
- Advantage out-of-pocket maximum
- The most the plan can charge you for in-network Medicare-covered services in a year. Every Advantage plan must set one; Original Medicare has no equivalent, which is the gap Medigap fills.
- Medicare-covered care you expect
- The total your providers would bill Medicare over the year, before any cost sharing. Not your share of it.
- Part B premium
- $202.90 a month for 2026 under the CMS annual determination. Payable on both routes, and increased by IRMAA at higher incomes on both routes equally.
- Part B deductible
- $283 for 2026. The only cost sharing a Plan G Medigap policy leaves you, which is why the Medigap total barely moves with the amount of care.
- Your share of care under Advantage
- A single percentage standing in for the copays and coinsurance an Advantage plan charges. Real plans charge per service rather than as one rate, so treat it as an approximation.
- Medigap open enrollment period
- A one-time six-month window beginning the first month you have Part B and are 65 or older, during which no insurer may refuse you or price you on health.
Frequently asked questions
Is Medigap or Medicare Advantage cheaper?
It depends entirely on how much care you use, and the page shows where the answer turns over. At the defaults — a $165 Medigap premium, a $40 Part D plan, a $0-premium Advantage plan with a $5,500 out-of-pocket maximum, and $12,000 of care — the Advantage route costs $4,835 against Medigap's $5,178, so Advantage wins by $343. Push the care to $40,000 and Medigap wins by $2,757, because its total does not move while the Advantage total climbs to its cap.
At what level of care does Medigap start winning?
Between $13,500 and $14,000 a year on these defaults. Running $13,500 of care gives Advantage a $43 edge; running $14,000 gives Medigap a $57 edge. Above that the Advantage cost keeps rising with the care until it hits the $5,500 out-of-pocket maximum at $27,500 of billed care, while the Medigap total stays flat at $5,178 all the way up. Your own crossover moves with the premiums you are quoted, so run it with your real figures.
What does a bad year cost on each route?
On the defaults, $5,178 on Medigap and $7,935 on Advantage. The Medigap worst case equals its ordinary case because Plan G covers everything Original Medicare leaves except the Part B deductible, so once you have paid the premiums and the $283 deductible there is nothing further to pay. The Advantage worst case is the premiums plus the plan's full $5,500 out-of-pocket maximum. That $2,757 spread is what the higher Medigap premium is buying: not a lower average cost, but a smaller range of outcomes.
Which Medigap plan does this page model?
Plan G, which is the common choice for people newly eligible for Medicare. Plan G covers everything Original Medicare leaves except the Part B deductible, so the deductible is the only cost sharing in the calculation. If you are pricing Plan N, expect copays for office and emergency visits and possible excess charges on top; if you are pricing a high-deductible Plan G, the premium is far lower but you pay up to the plan deductible first. Neither will reproduce this page's Medigap total without adjusting for those differences.
When can I buy a Medigap policy without medical underwriting?
During your Medigap open enrollment period, which is six months long and starts the first month you have both Medicare Part B and are 65 or older. In that window an insurer cannot refuse to sell you any policy it offers and cannot charge you more for pre-existing conditions. After it closes, medicare.gov states plainly that you may not be able to buy a Medigap policy at all, or it may cost more, because the insurer is allowed to apply medical underwriting. A limited set of guaranteed issue rights exists outside the window; your State Insurance Department is the authority on which apply to you.
Can I switch from Medicare Advantage to Medigap later?
You can always leave Advantage and return to Original Medicare during the annual enrollment period, but getting a Medigap policy to go with it is a separate question with a different answer. Outside your one-time six-month window, and outside the specific guaranteed issue situations, insurers in most states may underwrite you on health. This is the asymmetry that makes the initial choice more consequential than the annual cost comparison suggests: the money can be recalculated each year, but the option to buy Medigap may not still be there.