Medicare

Medigap or Medicare Advantage?

Medigap costs more up front but stays flat no matter how much care you use. Medicare Advantage often costs less up front but grows with your care, up to a yearly cap. The honest question isn't which one is "better" — it's how much care you'd need to use in a year before Medigap's steadier cost wins out, and what your state's rules mean for that premium over time and your right to switch later.

Your numbers

Start with an example, then adjust any number to match your own:

Where the two paths cross

The flat line is Medigap — premium plus the small Part B deductible, then near-total coverage no matter what happens. The rising line is Medicare Advantage, which grows with how much care you use until it hits its yearly cap. Where the rising line catches the flat one is your breakeven.

What it works out to

Your state's rules

These don't change this year's breakeven above — they matter for what happens in later years and if you want to switch paths after your initial enrollment window closes.

What this does and doesn't account for

The breakeven counts your own quoted premiums against a standard 20% Medicare coinsurance rate as a simplified stand-in for how Medicare Advantage cost-sharing typically works — real plans mix flat copays and coinsurance that vary by service and by specific plan, so treat the exact dollar breakeven as a useful estimate, not a guarantee. Medigap's own plan-letter differences (for example, Plan N's small office-visit copays) aren't modeled at this level of detail either.

The $283 Part B deductible folded into Medigap's cost comes from the Centers for Medicare & Medicaid Services (CMS) 2026 Part B premium and deductible notice. The $9,250 Advantage out-of-pocket cap shown as this tool's starting value (edit it to match your own plan) is the CMS-set 2026 in-network ceiling, from CMS's 2026 Part C bid review memorandum (Table 3).

It does not model prescription drug coverage on the Medicare Advantage side (most Advantage plans bundle it into the numbers already being compared), the extra benefits many Advantage plans include (dental, vision, hearing), or network restrictions. The state panel below shows whether your state guarantees Medigap issue when an employer changes (but doesn't fully drop) your retiree coverage — but only as a yes/no: the window length and exact scope of that right weren't independently confirmed for most of those states, so treat it as "this protection exists" information, not a substitute for checking your state's own rule before relying on it.

Also comparing a Roth conversion? The Roth conversion tool accounts for how Medicare Income-Related Monthly Adjustment Amount (IRMAA) surcharges interact with a conversion. The relocation tool models state income tax only and does not include IRMAA.

This is information to help you think, not financial advice.