What is Medicare Advantage vs Original Medicare Calculator?
A Medicare Advantage vs Original Medicare Calculator computes your exact age in years, months and days. It applies the standard formula to the values you enter and returns the result instantly, without sending any data to a server. Useful for paperwork, registration forms and birthday calculations.
Medicare Advantage vs Original Medicare Calculator
Compare estimated annual cost of Medicare Advantage vs Original Medicare + Medigap + Part D.
TLDR
Original Medicare + Medigap Plan G + Part D gives the broadest network with predictable cost (~$380 / mo total) but caps at the Medigap deductible. Medicare Advantage starts cheap (~$185 + $17 premium) but caps OOP at $9,350 - which can sting if you have a serious illness. Pick based on health stability + provider preference.
How to use this calculator
- Enter your inputs. Each field is labeled with its unit (dollars, percent, age, etc.).
- Read the result instantly. Numbers update as you type - no submit button.
- Adjust to test sensitivity. Change one input at a time to see what moves the result most.
- Cross-check the formula in the section below. Calculator math should match the published formula.
- Copy or screenshot the result for later. The site does not save anything; close the tab and inputs are gone.
About this tool + formula
This calculator uses real 2025-26 IRS, SSA, and CMS published values. The math runs entirely in your browser - nothing is sent to a server. The underlying formula is:
MA_annual = MA_premium*12 + min(visit_costs, 9350) + Part_B_premium*12 Original_annual = Part_B*12 + Medigap_G*12 + Part_D*12 + Plan_G_deductible_if_high
Sources: IRS contribution limits, SSA reduction factors, CMS Medicare premium tables, US Treasury auction yields, HHS Federal Poverty Guidelines. Numbers are refreshed annually as new figures publish.
Real-world scenarios where this calculator helps
Healthy seniors who travel
Original + Medigap goes anywhere any provider accepts Medicare. MA networks are usually regional. Snowbirds and frequent travelers often pick Original.
Low-income, low-utilization
MA usually has $0 monthly premium plus dental / vision / gym (Silver Sneakers). For the very healthy, MA can cost less - until something happens.
Chronic conditions
If you expect $20K+ of care, Original + Plan G means almost zero out of pocket beyond the Plan G deductible. MA caps at $9,350 but that is still a real bill.
Bundled benefits seekers
MA plans bundle dental, vision, hearing, and even fitness (gym). Original + Medigap does not include those - you would buy them separately.
What this tool does
- Compares estimated annual cost of Medicare Advantage vs Original + Medigap Plan G + Part D.
- Uses 2025 default values: Part B $185 / mo, MA average premium $17, Medigap Plan G ~$150, Part D ~$45.
- Caps MA out-of-pocket at $9,350 (2025 statutory max).
- Lets you set utilization (low / moderate / high) to see the breakeven.
- Reports monthly equivalent for both options.
What it does NOT handle
- Doesn't model the Part B IRMAA surcharge for high-income seniors (kicks in above $103K MAGI single).
- Doesn't model Part D LIS or Extra Help for low-income seniors.
- Doesn't compare specific MA plan networks or formularies.
- Doesn't account for state-specific Medigap pricing rules (e.g., NY community rated vs others underwritten).
- Doesn't include the late-enrollment penalty for Part B or Part D if you delayed signing up without creditable coverage.
Common mistakes and pitfalls
- Picking MA for the $0 premium without checking the network. If your specialist is not in network, you pay full price.
- Switching from MA back to Original later. Medigap insurers can underwrite you (and decline) outside the initial guarantee-issue window.
- Forgetting Part B premium of $185 / mo applies to BOTH options. The MA premium is in addition to Part B, not instead.
- Comparing only premiums and not OOP exposure. A $0-premium MA plan with $7K of expected utilization can cost more than Plan G.
- Skipping Part D when picking MA. Most MA plans include Part D, but some (MA-only, no drug) do not, and you face a late penalty if you skip drug coverage.
Frequently asked questions
What is Medicare Advantage?
Part C - private insurer plans approved by Medicare to provide Part A, Part B, and usually Part D in one bundle. Examples: Humana, UnitedHealth, Aetna, Kaiser MA plans.
What is Original Medicare?
Part A (hospital, free if you worked 40 quarters) + Part B (outpatient, $185 / mo in 2025). Has 20% coinsurance with no out-of-pocket cap unless you add Medigap.
What is Medigap Plan G?
The most popular supplement. Pays the 20% Part B coinsurance, hospital deductible, and most cost-sharing. You only pay the Part B annual deductible ($257 in 2025).
What is the Part B premium for 2025?
Standard $185.00 / mo. Higher-income beneficiaries pay IRMAA surcharges on top (up to $443.90 / mo at the highest tier).
What is the MA out-of-pocket max?
Statutory max is $9,350 in 2025 for in-network care. Some plans set it lower; out-of-network OOP can exceed this.
Can I switch between MA and Original?
Yes during the annual Open Enrollment Period (Oct 15 - Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1 - Mar 31). Switching back to Original may require Medigap underwriting outside the initial 6-month guarantee-issue window.
Do MA plans cover dental and vision?
Most include some dental, vision, hearing, and Silver Sneakers gym membership. The depth varies - read the Summary of Benefits.
What is Part D?
Prescription drug coverage. Standalone (with Original) or bundled into MA. 2025 average premium ~$45 / mo. The new $2,000 annual OOP cap on drugs took effect in 2025.