Original Medicare vs Medicare Advantage, Real 2026 Costs
Original Medicare plus Medigap has a fixed-cost feel. Medicare Advantage promises lower premiums but bundles in network restrictions. Here is the actual 2026 math, side by side.
Two paths through Medicare exist for most retirees: Original Medicare (Parts A and B) usually combined with a Medigap policy and a stand-alone Part D plan, or Medicare Advantage (Part C) which bundles A, B, often D, and frequently extras like dental and vision. The price tags read very differently.
Original Medicare 2026 baseline
Part A: $0 premium for most beneficiaries who paid 40+ quarters of Medicare taxes. Part B: $206.50 standard monthly premium plus IRMAA. Part D: average $36.78 monthly plus IRMAA. Out-of-pocket Part B coinsurance is 20% of Medicare-approved amounts with no annual cap.
Medigap layered on top
Medigap Plan G is the most common choice in 2026 for new enrollees. Premiums vary widely by state and age but commonly range $130-$220 per month per person. Plan G covers everything except the Part B deductible, eliminating the 20% coinsurance worry. Plan N is cheaper, $90-$160, with small copays per visit.
Total Original cost example
A 65-year-old woman in Tier 0 IRMAA picking Plan G in Texas might pay: $206.50 Part B + $36.78 Part D + $165 Plan G = $408.28 per month, or $4,899 per year. With Plan G she pays the $257 Part B deductible once a year and almost nothing else.
Medicare Advantage baseline
Many Medicare Advantage plans advertise $0 premium. The catch is they are still receiving the Part B base premium ($206.50) from your Social Security check, plus a Medicare payment to the insurer. So the real cost is at least $206.50 plus IRMAA. Many plans add small premiums on top, $20-$80, for richer benefits or extras like dental, vision, or hearing.
Total Advantage cost example
The same 65-year-old in Texas picking a $35/month Advantage HMO: $206.50 Part B + $35 plan = $241.50 per month, or $2,898 per year. Lower headline. But Advantage plans have copays per service, max out-of-pocket usually $4,000-$8,500 in-network, much higher out-of-network or no out-of-network coverage at all.
The catastrophic year
Healthy years strongly favor Medicare Advantage. A bad year (cancer, joint replacement, long hospitalization) can hit the Advantage out-of-pocket maximum, adding several thousand dollars on top of premiums. Original Medicare with Plan G keeps a bad year almost as cheap as a healthy year, which is why insurance economists call it the "expensive but predictable" path.
Network freedom
Original Medicare lets you see any provider that accepts Medicare nationwide, no referrals. Medicare Advantage uses HMO or PPO networks. Snowbirds, frequent travelers, and people in rural areas often value Original's flexibility enough to pay the Medigap premium.
Switching windows
You can switch from Advantage back to Original during the Annual Election Period (October 15 to December 7) but Medigap insurers may medically underwrite you, meaning a chronic condition could cost you guaranteed coverage. The one-time guaranteed-issue right at age 65 is the easiest entry to Original Medicare. Many advisors warn: if you start with Advantage at 65, you may not be able to switch back to Original Medigap later.