What is the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A & B) is government-run coverage that typically requires a Medigap supplement and Part D drug plan. Medicare Advantage (Part C) is private insurance that bundles Parts A, B, and usually D into one plan with networks and often lower premiums but potentially higher out-of-pocket costs.

How much does Original Medicare cost in 2025?

In 2025, Part B costs $185/month (standard premium), Part A has a $1,676 deductible if you need hospitalization, and Part B has a $257 deductible. Most people also add Medigap (averaging $125-$150/month) and Part D drug coverage (averaging $50/month).

Is Medicare Advantage cheaper than Original Medicare with a supplement?

Medicare Advantage plans often have lower monthly premiums (sometimes $0), but may have higher out-of-pocket costs through copays and deductibles. The better option depends on your health status, how often you see doctors, and your prescription drug costs. Use our calculator to compare based on your situation.

What is Medigap and do I need it?

Medigap (Medicare Supplement) is private insurance that covers the gaps in Original Medicare, like the 20% coinsurance for Part B services. If you choose Original Medicare, most people need Medigap to avoid potentially high out-of-pocket costs. Plan G and Plan N are the most popular options in 2025.

Can I switch from Medicare Advantage to Original Medicare?

Yes, you can switch during the Annual Enrollment Period (October 15 - December 7) or Medicare Advantage Open Enrollment (January 1 - March 31). However, switching to Original Medicare and buying Medigap may be difficult as insurers can deny coverage or charge higher rates based on health conditions, except during specific guaranteed issue periods.

What does Medicare Part D cover?

Medicare Part D covers prescription drugs. It's either purchased separately with Original Medicare or included in most Medicare Advantage plans. Part D plans have varying formularies (covered drug lists), premiums, deductibles, and copays. The average Part D premium in 2025 is around $50/month.

Which Medigap plan is best - Plan G or Plan N?

Plan G offers more comprehensive coverage with no copays after your Part B deductible, averaging $150/month. Plan N has lower premiums (around $125/month) but requires copays of up to $20 for doctor visits and $50 for ER visits. Choose Plan G if you want predictable costs, or Plan N if you're healthy and want to save on premiums.

Do Medicare Advantage plans have network restrictions?

Yes, most Medicare Advantage plans use HMO or PPO networks. HMO plans require you to use in-network providers and may need referrals to see specialists. PPO plans offer more flexibility but cost less when using in-network providers. Original Medicare with Medigap has no network restrictions - you can see any doctor who accepts Medicare nationwide.

What is the Medicare Advantage out-of-pocket maximum?

Medicare Advantage plans must have an annual out-of-pocket maximum (typically $3,000-$8,000). Once you reach this limit, the plan pays 100% of covered services for the rest of the year. Original Medicare has no out-of-pocket maximum, which is why Medigap is important for protecting against high costs.

When can I enroll in Medicare?

Your Initial Enrollment Period is 7 months: 3 months before your 65th birthday, your birthday month, and 3 months after. After that, you can switch plans during Annual Enrollment (October 15 - December 7) or the Medicare Advantage Open Enrollment Period (January 1 - March 31). Missing your initial period may result in late enrollment penalties.

Medicare Plan Comparison Calculator | Original vs Advantage

Compare Medicare Coverage Options

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Understanding Medicare Plan Options

Medicare decisions are permanent (or at least very difficult to undo), which makes getting it right the first time crucial. This calculator helps you compare Original Medicare with Medigap versus Medicare Advantage plans to find which actually costs less for your situation. The answer isn't obvious—it depends on your health, how often you see doctors, and whether you value network freedom over lower premiums.

Original Medicare vs Medicare Advantage

Original Medicare comes in two parts (A and B), but you'll need to add Medigap insurance and Part D for prescriptions. In 2025, expect to pay $185/month for Part B, another $150 or so for Medigap Plan G, and around $50/month for Part D—that's close to $385/month before you even see a doctor. Medicare Advantage bundles everything together, usually with lower monthly costs (sometimes $0), but you're stuck with their provider network. The calculator shows you which one actually costs less based on how much healthcare you use.

Medigap Plan Comparison - Plan G vs Plan N

If you go the Original Medicare route, you'll need a Medigap supplement. Plan G is the most comprehensive, covering basically everything after you meet the Part B deductible—no copays, no surprises, but you'll pay around $150/month. Plan N saves you about $25/month on premiums but adds $20 copays for doctor visits and $50 for ER visits. Which one's better depends on how often you see doctors. If you go every month, those $20 copays add up fast and Plan G becomes the better deal.

Medicare Cost Calculator 2025

The calculator uses 2025 Medicare rates: Part B premium is $185/month, Part B deductible is $257, and if you end up in the hospital, the Part A deductible is $1,676 per stay. For Medicare Advantage, you'll enter your specific plan's premiums, deductibles, and copays. The calculator then factors in your expected doctor visits and prescription costs to show your total annual expenses under each option—no guessing required.

Use this calculator to make an informed Medicare decision based on your actual healthcare needs and budget, not just the marketing materials.

Frequently Asked Questions

Common questions about Medicare plan options and costs