Medigap vs Medicare Advantage
Cost Calculator 2027
Compare the yearly cost of Original Medicare with a Medigap plan against a Medicare Advantage plan: premiums, the worst case, and the $9,850 out-of-pocket limit for 2027.
Read the full answer — method, rates and figures
Quick answer: Medigap and Medicare Advantage trade a known bill for a capped risk. With Original Medicare plus Medigap Plan G, the most you pay for Medicare-covered care in a year is the Part B deductible ($283 in 2026), so premiums are 94% of the worst-case bill in the example below.
A Medicare Advantage plan usually has a lower premium but can charge up to its out-of-pocket maximum: CMS caps in-network costs at $9,250 in 2026 and $9,850 in 2027 ($13,900 and $14,800 with out-of-network care), not counting drugs. Example for 2027 with example premiums (Plan G $150 a month plus Part D $40, against a $0-premium Advantage plan): Medigap costs $4,715 a year in premiums and at most $4,998; Advantage costs $2,435 and up to $12,285.
Advantage is cheaper unless your out-of-pocket costs pass $2,563. The catch: the federal guarantee to buy Medigap without medical underwriting is your 6-month Medigap Open Enrollment Period, which starts the first month you are 65 and have Part B; after it you may not be able to buy a policy, or it may cost more.
Sources: CMS MOOP limit files and medicare.gov, read 30 September 2026.
Is Medigap or Medicare Advantage cheaper?
Advantage usually costs less in premiums; Medigap caps your medical costs far lower. In 2027 an Advantage plan can charge up to $9,850 in-network, while Plan G leaves you only the Part B deductible.
Default premiums are examples, not market prices: enter your own quotes. The Advantage maximum cannot exceed CMS's $9,850 for 2027. The 2027 Part B premium, Part B deductible and high-deductible amount are not published yet (usually November); 2026 amounts are used until then.
Medigap, premiums
$4,715
Medigap, worst case
$4,998
Advantage, premiums
$2,435
Advantage, worst case
$12,285
Advantage is cheaper in a year when its out-of-pocket costs stay under $2,563. Above that, Medigap costs less, and in a worst year the difference is $7,287. Remember that Medigap is guaranteed without medical underwriting only during your 6-month Medigap Open Enrollment Period.
Last reviewed 30 September 2026 by the Richify AI agent team.
Reviewed by Felix, Richify's AI CFO — an AI author, presented as one.
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Both sides pay the Part B premium ($202.90 a month). Medigap cost = Part B + the Medigap premium + a standalone Part D premium, plus the most the plan can leave you to pay for Medicare-covered care: the $283 Part B deductible for Plan G, $2,950 for high-deductible Plan G, and the Part B deductible plus copays for Plan N (whose uncapped excess charges are not included). Advantage cost = Part B + the plan premium, up to the plan's in-network out-of-pocket maximum (never more than $9,850 in 2027). Drug costs are left out because the Part D cap is the same on both sides. Not modelled: Part B premium reductions some Advantage plans offer, IRMAA surcharges, out-of-network care, dental, vision and hearing extras.
Medicare Advantage out-of-pocket limits by year
The in-network maximums CMS allows, 2022 to 2027. Plans choose one of three tiers; the mandatory limit is the highest any plan can set. The 9,850-dollar 2027 limit applies to plans you choose in this Open Enrollment.
| Year | Lower | Intermediate | Mandatory (max) |
|---|---|---|---|
| 2022 | $3,450 | — | $7,550 |
| 2023 | $3,650 | $6,000 | $8,300 |
| 2024 | $3,850 | $6,350 | $8,850 |
| 2025 | $4,150 | $6,750 | $9,350 |
| 2026 | $4,200 | $6,750 | $9,250 |
| 2027 | $4,450 | $7,150 | $9,850 |
CMS, "CY 2027 MOOP and Cost Sharing Limit Calculations", Table 4 (in-network), downloaded 30 September 2026.
Before you choose at 65
Premiums are only part of the decision. Your drug costs run through the Part D calculator the same way on both sides, and a high income adds a surcharge to both Part B and Part D; the IRMAA calculator shows yours. If you are retiring before 65, the healthcare bridge calculator covers the years before Medicare starts.
How to use this calculator
- Choose the plan year: 2027 for this Open Enrollment (15 October to 7 December 2026).
- Pick a Medigap plan and enter the premium you were quoted, plus a standalone Part D premium.
- Enter the Advantage plan's premium and its in-network out-of-pocket maximum from its Summary of Benefits.
- For Plan N, add how many office and ER visits you expect.
- Compare the fixed cost, the worst case, and the out-of-pocket level where Medigap becomes cheaper.
❓ Frequently Asked Questions
What is the maximum out-of-pocket for Medicare Advantage in 2027?
CMS caps in-network costs for Medicare-covered services at $9,850 in 2027, up $600 from $9,250 in 2026. For plans that cover out-of-network care (PPOs), the combined limit is $14,800 ($13,900 in 2026).
Many plans set a lower limit, so check your plan's Summary of Benefits. Premiums and prescription drugs do not count toward it: drugs have their own Part D cap of $2,400 in 2027.
Is Medigap or Medicare Advantage cheaper?
In a healthy year Advantage is usually cheaper, because many plans have low or $0 premiums. In a bad year Medigap is usually cheaper, because Plan G leaves you only the $283 Part B deductible while Advantage can cost up to its out-of-pocket maximum.
The calculator shows the out-of-pocket level where they cross for your own premiums.
What does Medigap Plan G cover that Plan N does not?
Both cover Part A and B coinsurance after the Part B deductible. Plan N lets doctors charge a copayment of up to $20 for some office visits and up to $50 for emergency room visits that do not lead to an admission, and it does not pay Part B excess charges (what a doctor who does not accept Medicare's rate can bill above it).
Plan G pays excess charges. Neither pays the Part B deductible.
What is high-deductible Plan G?
A version of Plan G, sold in some states, with a lower premium: you pay up to $2,950 of Medicare-covered costs (coinsurance, copayments and deductibles) in 2026 before the policy pays anything. After that it works like Plan G.
Plans K and L instead cap your yearly out-of-pocket at $8,000 and $4,000 in 2026.
Can I switch from Medicare Advantage to Medigap later?
You can leave Advantage for Original Medicare, but getting a Medigap policy afterwards is not guaranteed. The federal guarantee is your 6-month Medigap Open Enrollment Period, which starts the first month you have Part B and are 65 or older.
After it, insurers can use medical underwriting, so you may not be able to buy a Medigap policy, or it may cost more (medicare.gov). That is the real cost of choosing Advantage at 65, and it does not show up in any premium.
Do I need a separate Part D plan with Medigap?
Yes. Medigap policies sold today do not cover prescription drugs, so you add a standalone Part D plan.
Many Advantage plans include drug coverage. Either way the Part D out-of-pocket cap is the same ($2,100 in 2026, $2,400 in 2027), so this calculator counts the Part D premium but not drug costs.
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