09/10/2026
Good article you might want to read before switching to a Medicare Advantage plan.
Medicare Advantage or Original Medicare—which one actually costs you more when you get sick?
55% of Medicare beneficiaries are now in Medicare Advantage plans. That’s 35.2 million people. But here's what most don't realize: the plan that looks cheaper in January can get very expensive in July.
Original Medicare gives you freedom—any doctor or hospital that takes Medicare, no referrals, no prior authorizations. You pay the standard Part B premium of $202.90 a month, and a $283 annual deductible. After that, Medicare pays 80% of most covered services. You can add a Medigap plan to cover the other 20%, but those premiums run extra.
Medicare Advantage plans often have low or even $0 premiums. They bundle drug coverage and sometimes dental, vision, or hearing. But they come with networks, prior authorizations, and out-of-pocket maximums. In 2026, the average out-of-pocket limit for Medicare Advantage is around $5,000—but some plans go as high as $8,850 for in-network care. If you go out of network, you could pay even more.
Here's what matters: there's no one-size-fits-all answer. If you're healthy and rarely see a doctor, a $0 premium Advantage plan might work. But if you have chronic conditions or want the freedom to see any specialist, Original Medicare plus a Medigap plan may protect you better.
Always check the plan's network, drug formulary, and out-of-pocket maximum before you enroll. And remember—you can switch plans during the Annual Enrollment Period from October 15 to December 7 each year.
Share this with someone on Medicare who's about to make this choice. It could save them thousands.
