Neither Medicare Advantage nor Original Medicare is always cheaper. The right comparison is between the specific options available where you live, including the Part B premium, any plan, Medigap, or Part D premiums, cost sharing for the care you expect to use, prescription costs, and—if you choose Medicare Advantage—the plan’s annual limit for covered medical services. Provider access matters too: a lower premium can be a poor fit if your doctors or hospitals are outside a plan’s network.
Medicare Advantage vs. Original Medicare: what affects the bill?
Original Medicare consists of Part A and Part B. You can add a separate Part D plan for prescription coverage and, if you choose, a Medigap policy to help pay certain Part A and Part B costs. Medicare Advantage, also called Part C, is an alternative way to receive Medicare-covered Part A and Part B services through a private plan. Most Medicare Advantage plans include Part D, but plan benefits and costs differ.
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In either arrangement, the Part B premium generally remains part of your budget. The standard Part B premium for 2026 is $202.90 per month; people with higher incomes may pay more. If you enroll in Medicare Advantage, you must continue paying your Part B premium. Some Medicare Advantage plans charge an additional plan premium, while others have a $0 plan premium. A $0 plan premium does not mean Medicare coverage has no monthly cost. Medicare.gov lists 2026 Medicare costs.
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A free scan shows the junk files, broken settings and background clutter dragging Windows down - then fixes them in one click.Free scan · Windows 10 & 11For Original Medicare, the total monthly premium picture may also include a Part D premium and, if purchased, a Medigap premium. Those amounts depend on the plan or policy you select. For Medicare Advantage, check whether the plan charges an additional premium and whether its prescription coverage is included. Compare premiums alongside deductibles and cost sharing—not in isolation.
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It helps to separate costs into two categories. Premiums are recurring amounts you pay to maintain coverage; cost sharing is what you owe when you receive covered care or fill prescriptions. A plan with a higher monthly premium could have different deductibles or copayments from one with a lower premium. The right comparison is therefore not just “What will I pay every month?” but also “What could I owe when I use care, and what services and providers can I use under these terms?”
How much does Medicare cost in 2026?
These figures are national 2026 reference amounts, not a quote for a particular person or plan. The standard Part B premium may be higher based on income, and plan-level costs vary.
- Part B premium: $202.90 per month for the standard premium.
- Part B deductible: $283.
- Part D covered-drug out-of-pocket threshold: $2,100 before catastrophic coverage applies.
- Maximum Part D deductible: $615; a Part D plan may charge less.
The Part B premium and deductible are published by the Centers for Medicare & Medicaid Services on Medicare’s 2026 costs page. The Part D threshold and maximum deductible are described on Medicare.gov’s Part D costs page. These are different parts of Medicare: do not treat the Part D drug threshold as the annual medical-cost limit for a Medicare Advantage plan.
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1Fix the driver behind crashes, sound loss and screen glitches2Repair Windows errors before they cause bigger problems3Scan for outdated or missing drivers - takes under a minuteThe 2026 figures are useful starting points, but they do not tell you the premium or cost sharing for a particular Medicare Advantage or Part D plan. Likewise, the standard Part B premium is not necessarily the amount every beneficiary pays, because higher-income beneficiaries may pay more. Check the current figures and your own premium notices when planning a budget, and check the plan’s current documents for any plan-specific amounts.
What is the difference in out-of-pocket costs?
| Cost or coverage question | Original Medicare | Medicare Advantage |
|---|---|---|
| Part B premium | You pay the Part B premium. | You continue paying the Part B premium to remain in the plan. |
| Other monthly premiums | A separate Part D premium may apply. Medigap, if purchased, has its own variable premium. | A plan premium may apply; some plans have a $0 plan premium. Most plans include Part D. |
| Medical cost sharing | For Part B-covered services, the usual share is 20% of the Medicare-approved amount after the deductible. | Deductibles, copayments, and coinsurance vary by plan and service. |
| Annual limit for covered medical costs | Medicare itself has no general yearly out-of-pocket limit unless you have other coverage, such as Medigap, Medicaid, or employer coverage. | The plan sets a yearly limit for covered Medicare services. In-network and out-of-network limits may differ. |
| Prescription coverage | You can add a separate Part D plan. | Most plans include Part D; check the plan’s drug coverage and costs. |
| Supplement coverage | Medigap may help pay certain Part A and Part B costs. | Medigap does not cover Medicare Advantage cost sharing. |
| Provider access | You can use providers that take Medicare; whether a provider accepts assignment can affect what you owe. | Non-emergency care may require using providers in the plan’s network and service area. Network and referral rules vary. |
This is a structural comparison, not a prediction of your personal spending. Medicare’s official Original Medicare and Medicare Advantage comparison explains that costs and plan rules vary.
The annual-limit row is especially important. Medicare.gov explains that Original Medicare has no yearly limit on out-of-pocket spending unless you have supplemental or other insurance, such as Medigap, Medicaid, employer, retiree, or union coverage. Medicare Advantage plans set a yearly limit for covered Medicare services, and the in-network and out-of-network limits may not be the same. The limit is not one national amount: you need the limit listed for the specific plan and year you are evaluating.
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How Original Medicare cost sharing works
Part B services
After you meet the Part B deductible, the usual cost share for Part B-covered services is 20% of the Medicare-approved amount. That percentage does not by itself tell you your full yearly exposure: the total depends on which covered services you use and their approved amounts. Medicare itself does not set a general annual out-of-pocket ceiling for Original Medicare. Without other coverage, costs can continue to accumulate during the year.
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In other words, the 20% figure is not a fixed annual bill and does not mean every service costs the same amount. It is the usual share for covered Part B services after the deductible, calculated against the Medicare-approved amount. Your overall spending depends on how much covered care you receive and whether another form of coverage helps pay the remaining costs. That is why comparing only a percentage with a Medicare Advantage copayment can give an incomplete picture.
Why people add Medigap
A Medigap policy can help pay certain Part A and Part B costs, changing how much of those costs you pay yourself. It has an additional premium, so compare that premium with the cost sharing the policy may help cover. In most states, policies are standardized by letter, but companies can charge different prices for the same letter. Prices also depend on location and other factors. Medicare.gov’s Medigap policy information explains how to find options. Medigap is for use with Original Medicare; it cannot pay Medicare Advantage out-of-pocket costs.
Standardization can make it easier to compare the benefits of policies with the same letter, but it does not make their premiums identical. When comparing Medigap choices, consider both the lettered policy’s benefits and the price offered by each company in your location. A Medigap premium is an ongoing cost, so include it in the monthly total rather than treating it as a one-time purchase. If you are comparing Original Medicare with and without Medigap, show those as separate scenarios: the premium and the cost sharing you may pay can both change.
Prescription coverage is a separate cost decision
With Original Medicare, you can choose a standalone Part D plan. Compare its premium, deductible, covered-drug list (formulary), pharmacy arrangements, and your cost sharing for the medicines you take. The annual Part D drug threshold is relevant to covered-drug spending, not a cap on every medical bill. A plan’s specific terms determine what you pay before and after that threshold.
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Outbyte Driver Updater FREEScan for outdated or missing drivers - takes under a minuteDriver Scan →Outbyte PC Repair FREEClear out junk files and repair common Windows errorsFree Scan →The 2026 Part D covered-drug out-of-pocket threshold is $2,100, and a Part D plan may charge a deductible of up to $615; it may charge less. These are general program figures, not a promise that every plan has the same deductible or that every prescription will cost the same amount. Check that each medicine is covered by the plan, whether your preferred pharmacy is included, and what the plan’s cost-sharing rules say. With Medicare Advantage, most plans include Part D, but inclusion alone does not establish that your specific drugs or pharmacy will be treated favorably.
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How Medicare Advantage cost sharing works
Medicare Advantage plans set their own cost-sharing arrangements, which may include deductibles, copayments, and coinsurance for different services. A plan also sets a yearly out-of-pocket limit for covered Medicare services. That limit is plan-specific, and a plan may have different limits for in-network and out-of-network services. Do not substitute one plan’s limit—or a remembered figure from a prior year—for the limit of the plan you are considering.
The annual limit is useful protection against covered medical cost sharing, but it does not make every expense part of the limit. Premiums, prescription expenses, and services not covered by the plan need to be evaluated separately under the plan’s terms. Most Medicare Advantage plans include Part D, but the drug coverage still varies: check each medication, pharmacy, and applicable cost sharing rather than assuming inclusion means a particular prescription will be inexpensive.
Network and service-area rules also influence real cost. Before choosing a plan, check whether your doctors and hospitals participate, whether you need referrals, and whether prior authorization applies to care you expect to use. Confirm how the plan handles out-of-network services; do not assume every provider who accepts Medicare will be treated as in-network by a Medicare Advantage plan.
For a fair comparison, look beyond the plan’s headline premium and limit. Find the plan’s deductible and the listed cost sharing for the types of services you are likely to use. Then check whether your providers are in the network and whether the plan requires a referral or prior authorization for relevant care. A plan’s service area matters as well: availability and rules are tied to the specific plan and area, so a plan someone else has may not be an option where you live.
How to compare your actual options
Use the same assumptions for each option: your location, the providers you want to keep, your prescriptions, and the care you reasonably expect to need. Medicare.gov directs consumers to compare specific plan costs because the amounts vary. A practical comparison has four parts.
- List fixed monthly premiums. Start with your Part B premium. Add the Medicare Advantage plan premium, if any, or the separate Part D and Medigap premiums for an Original Medicare setup. Keep each premium visible rather than collapsing the choices into a $0-versus-paid plan comparison.
- Estimate medical cost sharing for your expected care. For Original Medicare, account for the Part B deductible and the usual coinsurance for Part B-covered services, then assess how a Medigap policy would change those costs. For Medicare Advantage, use the plan’s own deductible, copayments, and coinsurance for the services you expect to use.
- Check prescriptions plan by plan. For Original Medicare, compare standalone Part D options. For Medicare Advantage, inspect the included drug coverage. Check that your medications are covered, which pharmacies are available, and what cost sharing applies. The 2026 Part D figures are useful context, but your plan’s premium, formulary, deductible, and pharmacy terms determine your actual costs.
- Compare access and the annual medical limit. Verify doctors, hospitals, service area, referral rules, prior authorization, and out-of-network treatment for each Medicare Advantage plan. Record its annual limit and whether separate in-network and out-of-network limits apply. For Original Medicare, include any other coverage you have when assessing the absence of a general Medicare out-of-pocket limit.
A useful worksheet separates monthly premiums, expected medical cost sharing, prescription costs, and provider-access constraints. Keep a second, less predictable-care scenario if your needs may change: the Medicare Advantage plan’s covered-service limit can help frame medical exposure, while Original Medicare without supplemental coverage has no general yearly cap. Do not turn an uncertain estimate into a promise of what you will spend.
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For each option, make the comparison specific enough that you can see which assumptions drive the result. For example, list the doctors and hospitals you want to use rather than simply marking “network checked.” Write down your medicines and pharmacies rather than assuming all Part D coverage is equivalent. Note the plan year next to each deductible, copayment, premium, and annual limit; figures from a previous year or a different plan should not be treated as current terms.
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Then compare at least two care-use patterns if your expected needs are uncertain: the services you currently anticipate and a scenario with more covered care. This is not a guarantee of future spending. It is a way to notice how premiums, service-level cost sharing, and the Medicare Advantage plan’s medical limit affect the choices differently. For Original Medicare, account for whether you would have Medigap, Medicaid, employer coverage, or another supplement, since that changes the out-of-pocket picture.
Do not add numbers that describe different things as though they were interchangeable. The $2,100 Part D threshold concerns covered-drug out-of-pocket spending, while the Medicare Advantage annual limit applies to covered Medicare services under the plan’s terms. The $283 Part B deductible is another separate figure. Keep medical and prescription costs distinct in the worksheet, and consult the plan details to understand how each applies.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Which option may fit better?
Original Medicare may suit you when provider flexibility is a priority
Original Medicare can be appealing if you want to use providers that take Medicare and are prepared to select separate prescription coverage and, potentially, Medigap. Its cost picture is less predictable without other coverage because Medicare itself does not impose a general annual out-of-pocket limit. If you are considering Medigap, include its premium and compare policies available in your location; standardized letter benefits do not mean identical prices.
Medicare Advantage may suit you when a plan’s structure fits your care
A Medicare Advantage plan may be attractive if its provider network, service area, drug coverage, and cost-sharing rules work for you, especially if you value having a plan-specific annual limit for covered medical services. But premiums alone are not enough to judge affordability. A $0 plan premium still sits alongside the Part B premium and plan-specific costs for care, prescriptions, and potentially out-of-network services.
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The lowest monthly premium, the lowest deductible, or the highest annual limit cannot independently determine the lowest total cost. Your doctors, prescriptions, expected care, and other coverage can change the comparison. Use the actual plan documents and current local options; no location-specific quote or individualized total-cost estimate is established here.
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The practical question is not which label is cheaper in the abstract. It is which combination of premiums, cost sharing, covered medicines, provider access, and supplemental coverage fits your situation. Two people in different locations—or two people with different doctors, prescriptions, and expected care—can reasonably arrive at different comparisons. Verify the terms for the options available to you instead of relying on a national average or another person’s experience.
Common comparison mistakes
- Calling a $0 plan premium free Medicare: The Part B premium remains payable, and medical and prescription cost sharing still varies.
- Treating Original Medicare as if it has an annual cap: It has no general yearly limit unless other coverage applies.
- Comparing only premiums or only coinsurance: Include deductibles, copayments, prescriptions, Medigap or plan premiums, and applicable annual limits.
- Assuming one Medicare Advantage limit applies everywhere: The amount is plan-specific and may distinguish in-network from out-of-network care.
- Assuming all medicines or providers are treated alike: Check the specific drug formulary, pharmacy, doctors, hospitals, network, and plan rules for each option.
- Using the Part D threshold as a medical-care cap: The $2,100 threshold is for covered-drug spending, not a universal limit on medical bills.
- Comparing figures from different years: Premiums, deductibles, and plan limits may change. Match each figure to the coverage year and plan you are considering.
- Ignoring other coverage: Medigap, Medicaid, employer, retiree, or union coverage can change what you pay under Original Medicare; include it in the comparison.
Where to verify current costs and coverage
Use Medicare.gov’s Medicare costs page for current Part B figures, its Part D costs page for drug-coverage information, and its coverage comparison to review the structural differences. For Medigap, consult Medicare.gov’s policy information. Plan costs and availability depend on the choices available in your area; verify the details for the year you are selecting coverage.
The Centers for Medicare & Medicaid Services publishes annual cost figures, and Medicare.gov provides the comparison tools and plan information described above. Use those official pages to confirm current amounts, then review the specific plan or policy details before making a choice. A national standard premium or general comparison page cannot replace a location-specific review of available plans, provider networks, prescription coverage, and individual circumstances.
Frequently Asked Questions
Does a $0 Medicare Advantage plan mean I pay nothing each month?
No. You must continue paying the Part B premium to remain in Medicare Advantage. The standard Part B premium is $202.90 per month in 2026, though higher-income beneficiaries may pay more. A $0 plan premium only means the plan itself charges no additional monthly premium; deductibles, copayments, coinsurance, and prescription costs may still apply.
Which has an annual out-of-pocket limit: Original Medicare or Medicare Advantage?
Medicare Advantage plans set a yearly limit for covered Medicare services, and in-network and out-of-network limits may differ. Original Medicare has no general yearly out-of-pocket limit unless you have other coverage, such as Medigap, Medicaid, or employer coverage.
Is the $2,100 Part D threshold the same as a Medicare Advantage medical out-of-pocket limit?
No. The $2,100 2026 threshold applies to out-of-pocket spending on covered Part D drugs before catastrophic coverage applies. A Medicare Advantage plan’s yearly limit concerns covered Medicare services and is specific to that plan. Review drug costs and medical cost sharing separately.
Can I use Medigap with Medicare Advantage?
No. Medigap helps pay certain Part A and Part B costs when you have Original Medicare; it does not cover Medicare Advantage out-of-pocket costs. Medigap policies have their own premiums, and prices can differ among companies even for the same standardized letter policy.
How should I compare Medicare Advantage and Original Medicare costs?
Compare the actual options available where you live. Include the Part B premium, any plan, Part D, or Medigap premiums, deductibles and service-level cost sharing, prescription coverage for your medicines, provider access, and the Medicare Advantage plan’s annual limit. Also account for other coverage you have and verify current plan-year terms.
The Bottom Line
There is no universal cost winner. In 2026, the standard Part B premium is $202.90 per month in either arrangement, while premiums and cost sharing beyond that depend on the coverage you choose. Original Medicare has no general annual out-of-pocket limit unless other coverage applies; Medicare Advantage has a plan-specific limit for covered Medicare services. Compare the actual plans, medicines, providers, and coverage available where you live—not just the monthly premium.
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