Medicare Supplement vs Advantage Total Cost Analyzer

Compare Medigap and Medicare Advantage costs side by side before you pick coverage. Enter your Medigap premium and expected coinsurance, the Advantage out-of-pocket cap and premium, and optional annual medical spend to see total cash outlay, utilization of the Advantage cap, and the claim level where one plan overtakes the other.

Enter the total annual premium for the Medigap plan under review (12 × monthly rate).
Use the in-network maximum out-of-pocket limit listed in the Advantage Summary of Benefits.
Add expected coinsurance, excess charges, or foreign travel coverage left to you after Medigap pays.
Multiply the Advantage monthly premium by 12 to compare with Medigap; defaults to $0 when blank.
Model the medical bills you expect this year; blank treats it as the full Advantage out-of-pocket cap.

Examples

  • $2,260 Medigap premium, $450 residual bills, $5,400 Advantage cap, $35 Advantage premium, $3,200 expected spend ⇒ Medigap totals $2,710.00 USD, Advantage totals $3,620.00 USD, so Medigap is cheaper by $910.00 USD while Advantage uses 59.26% of its cap.
  • $1,980 Medigap premium, $0 coinsurance, $4,800 Advantage cap, $95 Advantage premium, $6,200 projected spend ⇒ Medigap stays at $1,980.00 USD while Advantage reaches $5,940.00 USD, meaning Medigap wins by $3,960.00 USD even before valuing provider access.

FAQ

How do Part B givebacks or flex cards affect the comparison?

Subtract givebacks or add-on benefits from the Advantage premium input so the calculator reflects the net cash you actually pay each month.

Should prescription costs be added here?

Layer Part D or MAPD drug spending into the expected medical bills input for Advantage, and add comparable Medigap prescription costs to the coinsurance field so both paths reflect pharmacy usage.

What if I travel frequently outside my Advantage service area?

Consider the Advantage plan's out-of-network cap or supplement travel coverage costs in the Advantage premium input so the comparison includes access considerations beyond pure cash spend.

Can I include dental, vision, or hearing add-ons?

Yes. Add the annual value of extra benefits to the appropriate cash field—either as additional Medigap coinsurance or as part of the Advantage premium—so the total reflects ancillary coverage you rely on.

Additional Information

  • The Advantage premium field multiplies the monthly amount by 12 so annual cash outlay is comparable to the Medigap premium.
  • Expected medical bills cap at the Advantage MOOP, recognizing that you never pay above the plan's limit in-network.
  • Net difference shows which path costs less and by how much, helping retirees compare options alongside doctor networks and benefits.
  • Break-even spend reports the claim level where Advantage matches the Medigap total so you can stress-test low-utilization scenarios.

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