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Medicare Advantage vs Medigap Calculator

Compare 10-year total cost: $0-premium Medicare Advantage with copays and max-out-of-pocket vs Medigap premiums with near-zero bills.

Short answer

Medicare Advantage vs Medigap Calculator

$6,30010-year Medicare Advantage cost

MA saves ~$21,011 over 10 years at your usage level — but one bad year can hit the ~$8,300 out-of-pocket max, and switching back to Medigap later usually requires medical underwriting.

How it's calculated: vs $27,311 for Medigap over the same 10 years. Adjust the inputs below to recalculate for your own numbers.

Disclaimer: Estimates only — not insurance, tax, or legal advice. Actual premiums depend on underwriting, state, carrier, claims history, and plan details. Confirm numbers with a licensed agent, broker, or Healthcare.gov before acting.

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65
8
1
$0.00
$145
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Formula used

Total cost = premiums + expected copays

Advantage bets on staying healthy: low or zero premiums but per-service copays up to an ~$8,300 annual cap. Medigap pre-pays the risk in premiums. The crossover point is usually 15–20 visits a year plus any hospitalization.

MA = (premium × 12 + visits × copay + hospital share) × 10; Medigap = (premium × 12 + deductible) × 10 × age growth
MA out-of-pocket max (2026)
~$8,300/yr
Average MA premium
$0–40/mo
Enrollees choosing MA
~54%
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The underwriting trap most people miss

Your Medigap open-enrollment window at 65 is one-time. If you choose Advantage now and want Medigap at 72, carriers in most states can deny you or charge more for pre-existing conditions. The cheap MA premium today can lock you into MA networks permanently.

  • MA plans can change networks and drug formularies every January.
  • Medigap works with any doctor who takes Medicare, nationwide.
  • Snowbirds and travelers almost always want Medigap.

FAQ

Is Medicare Advantage really cheaper?

In healthy years, yes — often by $1,500–2,500/yr. In a year with a hospitalization plus regular specialist visits, copays can reach the ~$8,300 out-of-pocket maximum, erasing years of savings in one bad year.

Can I switch from Advantage to Medigap?

You can enroll during annual election periods, but outside your initial 6-month window (or a 12-month trial right), Medigap carriers can medically underwrite — and decline you. Guaranteed-issue rights exist but are narrow.

Does Advantage include dental and vision?

Most MA plans bundle some dental, vision, hearing, and drug coverage — Medigap does not (you'd add standalone Part D). That convenience is MA's biggest genuine advantage.

How this calculator is built

Independently maintained

Written by Sam Doshi and the RevenueLab editorial team. We don't sell the data feeds this tool is built on.

Sourced from primary data

Benchmarks come from public AdSense / Stripe / IRS disclosures and reader-submitted data — never third-party "$X per view" claims. Full methodology.

Last editorial review

Reviewed on a rolling quarterly cycle. Dated reviews are published on the methodology record for each calculator.

Editorial standards

See our editorial policy and disclaimer. Results are estimates, not advice.

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