Will a Medicare Advantage plan save you money?

What Medicare Advantage actually is

A Medicare Advantage plan (also called Part C) replaces how you use Original Medicare: a private insurer takes over, and you use its provider network, its copays, and its approval rules instead of Medicare's 80/20 arrangement. In exchange, most plans bundle in drug coverage and extras like dental, vision, and hearing, and every plan has a yearly in-network out-of-pocket maximum — something Original Medicare famously lacks.

Nothing about these plans is standardized. Each one sets its own premium, copays, network, and prior-authorization rules, county by county, and can change all of it every January 1. That's the single most important difference from Medigap, where a Plan N is identical from every company. How that plays out for lab tests →

The light-year math, with real numbers

We ran a real person's three healthy-ish years (one ER visit, a follow-up, an office visit, routine blood work) through the three ways of carrying Medicare, using a real $0-premium plan's published copays:

Every option also includes the Part B premium (about $2,435 in 2026), which you pay no matter what — yes, even on a "$0 premium" Advantage plan.

That ordering — Advantage cheapest, bare Original Medicare close behind, Medigap far more expensive — is typical for people who use little care. It reverses hard in a heavy year: a hospitalization with months of follow-up costs a Medigap Plan G holder a few hundred dollars, an Advantage member several thousand (up to the plan's maximum), and a bare Original Medicare patient a potentially unlimited 20% share.

Run your own numbers instead of trusting our example: the Medicare cost comparison takes what you actually paid — it can even read your medicare.gov claims file, privately, in your own browser — and compares all three options side by side.

The letter to read before you shop: the ANOC

Every fall, your current plan mails an "Annual Notice of Change" — the list of what gets worse (or better) on January 1: premium, copays, the drug list, which doctors are still in network. That letter, not advertising, is the reason to shop. If your plan's ANOC shows your doctor leaving the network or a drug moving to a pricier tier, comparing plans is worth an evening; if nothing changed and you're happy, switching for a gift card rarely pays.

The shopping window (Medicare calls it Open Enrollment; the industry says "AEP") runs October 15 – December 7 every year, changes effective January 1. People already in an Advantage plan get one more chance — one switch, or a return to Original Medicare — between January 1 and March 31. The official comparison tool is medicare.gov/plan-compare, and your State Health Insurance Assistance Program (SHIP) will walk through it with you by phone, free, with nothing to sell.

The one-way door almost nobody mentions

"I'll try Advantage, and switch back if I don't like it" hides a trap. You can always return to Original Medicare in an enrollment window — but Original Medicare alone leaves that unlimited 20% share, so most people returning also want a Medigap policy. And buying Medigap after your first six months on Part B means passing medical underwriting in most states: the company can ask your health history and say no.

• The exception that matters: if you joined a Medicare Advantage plan when you were first eligible for Medicare and leave within 12 months, federal law guarantees your right to buy a Medigap policy — the "trial right." A similar right applies if you dropped a Medigap policy to try Advantage for the first time.
• Other guaranteed openings: your plan leaves your county or shuts down, you move out of its service area, or the plan breaks its rules. Outside those, health questions apply.
• The full picture of when the Medigap door opens and closes: Can you still get Medigap after 65? →

What to check besides price

• Your doctors and hospital, by name, in the plan's directory — networks are the product's real price.
• Your drugs, by name, in the plan's formulary, at your pharmacy.
• The out-of-pocket maximum, which is your true worst-case bill for the year, not the premium.
• Prior authorization — ask which common services need the plan's permission first.