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Medigap vs Advantage

Compare total yearly cost of Medigap plus a Part D plan against a Medicare Advantage plan's premium and out-of-pocket.

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Medigap + Part D total (yr),
Advantage total (yr),
Difference,

A side-by-side estimate only; real plan costs shift with your health, ZIP code, and the carriers available there.

Naomi Foster
By Naomi Foster, Contributing Writer, Healthcare
Updated July 9, 2026

How the totals are calculated

The tool adds twelve months of Medigap premium to twelve months of Part D premium, then adds your expected Medigap out-of-pocket spending for the year. That sum is compared against twelve months of Advantage premium plus your expected Advantage out-of-pocket spending. Whichever total is lower is labeled the cheaper path for the numbers you entered.

Medigap = predictable; Advantage = lower premium but pay-as-you-go up to a cap.

Worked example using the default numbers

With the defaults loaded, a $145 Medigap premium plus a $40 Part D plan plus $283 in expected out-of-pocket comes to $145×12 + $40×12 + $283 = $2,503 for the year. A $0-premium Advantage plan with $3,000 in expected out-of-pocket comes to $0×12 + $3,000 = $3,000 for the year. In this healthy-to-moderate-use scenario Medigap comes out about $497 ahead for the year, even though its monthly premium is the higher of the two. Raise the Advantage out-of-pocket figure toward a plan's actual annual maximum, which can run into the thousands, and the gap widens further in Medigap's favor.

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Good to know

FAQs

What should I use for my Advantage out-of-pocket estimate?

Look at your actual claims from the last year or two if you have them, or use your plan's stated out-of-pocket maximum as a worst-case number and a low estimate like $500 to $1,500 as a healthy-year number. Running both gives you a realistic range instead of one guess.

Why does the tool ask for a Part D premium separately?

Medigap never includes prescription drug coverage, so anyone comparing Medigap to a Medicare Advantage plan that bundles Part D needs to add a standalone drug plan into the Medigap side to make the comparison fair.

My Advantage plan has a $0 premium. Does that make it automatically cheaper?

Not necessarily. A $0 premium only covers one side of the ledger. Run your expected out-of-pocket costs through the calculator too; in a high-use year, copays and coinsurance under Advantage can outpace what you would have paid in Medigap premiums.

Does this tool account for provider networks?

No, it only compares dollars. Medigap works with any Medicare-accepting provider nationwide, while most Advantage plans restrict you to an HMO or PPO network. Factor network access into your decision separately from the cost totals here.