Medicare Plan Comparison Tool

Understanding Your Medicare Options in 2026

Medicare provides health insurance for Americans aged 65 and older (and some younger people with disabilities). All paths start with Original Medicare — Part A (hospital insurance) and Part B (medical insurance). From there, you have three main choices for how to structure your coverage:

• Original Medicare + Medigap + Part D — Maximum flexibility, predictable costs, higher premiums
• Medicare Advantage (Part C) — Bundled coverage through a private insurer, lower premiums, network restrictions
• Original Medicare Only + Part D — Lowest premiums, but 20% coinsurance and hospital deductibles are your responsibility

Original Medicare + Medigap (Supplemental Insurance)

Medigap policies are sold by private insurers and cover cost-sharing gaps in Original Medicare — deductibles, coinsurance, and copayments. Plan G is the most popular plan for new enrollees (Plan F closed to new members in 2020). Plan G covers everything except the Part B deductible ($283 in 2026).

Medigap pricing methods vary by insurer:

• Attained-age rated: Premiums increase as you get older (most common)
• Issue-age rated: Based on your age when you buy the policy; doesn't increase due to age
• Community-rated: Same premium regardless of age

Your Medigap Open Enrollment Period — the 6 months starting when you turn 65 and are enrolled in Part B — is the best time to buy. During this window, insurers must sell you any Medigap policy at the standard rate regardless of health status (guaranteed issue).

Medicare Advantage (Part C)

Medicare Advantage plans are offered by Medicare-approved private insurers as an alternative to Original Medicare. Most MA plans bundle Part D drug coverage and often include extra benefits like dental, vision, hearing, and fitness programs.

Key considerations:

• Network restrictions: HMO plans require using in-network providers; PPO plans offer out-of-network coverage at higher cost
• Maximum out-of-pocket: MA plans cap your annual out-of-pocket spending (the CMS limit for 2026 is $8,850 for in-network services, though many plans set lower limits around $5,000)
• Star ratings: CMS rates plans 1–5 stars based on quality metrics — higher-rated plans may offer better benefits
• Annual switching: You can change MA plans during the Annual Enrollment Period (Oct 15 – Dec 7) or switch back to Original Medicare during the Open Enrollment Period (Jan 1 – Mar 31)

Part D Prescription Drug Coverage in 2026

The Inflation Reduction Act made major changes to Part D starting in 2025, with continued benefits in 2026:

• $2,100 out-of-pocket cap: Once your true out-of-pocket drug spending reaches $2,100, you pay nothing more for covered drugs for the rest of the year
• $35 insulin cap: Monthly cost for covered insulin is capped at $35
• No coverage gap ("donut hole"): The gap has been eliminated
• $615 maximum deductible: Plans may set a lower deductible or none at all
• Medicare Prescription Payment Plan: You can spread your out-of-pocket drug costs into predictable monthly payments throughout the year

Part D plans use formulary tiers (generic, preferred brand, non-preferred brand, specialty) with different copay or coinsurance amounts at each level. Choosing a Part D plan that covers your specific medications at the lowest cost is important — use Medicare's Plan Finder at medicare.gov to compare.

IRMAA: Income-Related Monthly Adjustment Amount

If your modified adjusted gross income (MAGI) exceeds certain thresholds, you pay higher Part B and Part D premiums. This surcharge is called IRMAA. Key facts:

• 2-year lookback: 2026 IRMAA is based on your 2024 tax return
• 6 tiers: Standard (no surcharge) through Tier 5 (highest income)
• Part B impact: Standard premium is $202.90/mo; Tier 5 is $689.90/mo
• Part D impact: Surcharge of $14.50 to $91.00/mo added to your Part D plan premium
• Appeals: If you've had a life-changing event (retirement, divorce, death of spouse), file SSA-44 to use a more recent tax year
• Strategies: Roth conversions, timing of capital gains, and managing retirement account withdrawals can help minimize IRMAA exposure

Key Enrollment Periods

• Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, your birthday month, 3 months after)
• Annual Enrollment Period (AEP): Oct 15 – Dec 7 each year — switch MA plans, change Part D plans, or switch between Original Medicare and MA
• Open Enrollment Period (OEP): Jan 1 – Mar 31 — MA enrollees can switch to a different MA plan or drop MA and return to Original Medicare (with a Part D plan)
• Special Enrollment Periods: Triggered by qualifying events (moving, losing employer coverage, etc.)
• Late enrollment penalties: Delaying Part B or Part D enrollment without qualifying coverage can result in permanent premium penalties

How to Choose the Right Path

Consider these questions when deciding:

• Do you want predictable costs? Medigap provides the most cost certainty; Original Medicare alone has the least
• Do you want provider choice? Original Medicare (with or without Medigap) lets you see any Medicare-accepting provider nationwide. MA plans use networks.
• How important is drug coverage? All three paths can include Part D, but MA plans bundle it
• Do you travel frequently? Original Medicare works nationwide; MA plans may not cover care outside their service area (except emergencies)
• Do you have chronic conditions? Medigap's comprehensive coverage can protect against high costs; MA plans offer care coordination programs

2026 Cost Reference

Source: CMS 2026 Medicare Parts A & B Premiums and Deductibles fact sheet (Nov 14, 2025); SSA IRMAA tables.

Methodology

This tool estimates annual Medicare costs using the following assumptions:

• Medigap premiums are national averages for Plan G (attained-age rated). The base premium of $220/month at age 65 increases 3% per year of age.
• Medicare Advantage costs use a typical plan structure: $14/mo premium, $20–$40 doctor copays (varies by health status), $350/day hospital copay for days 1–5, and a $5,000 typical plan out-of-pocket maximum.
• Hospital utilization is probability-weighted by self-reported health status (5% for Excellent to 35% for Below Average).
• Prescription drug costs are estimates by tier — actual costs depend on your specific medications and Part D plan formulary.
• IRMAA brackets are based on the 2-year lookback rule (2024 income for 2026 premiums).
• This tool does not account for employer-sponsored retiree coverage, Medicaid dual eligibility, VA benefits, or FEHB plans.

Related Tools

• Healthcare Cost Estimator — Estimate total healthcare spending across your entire retirement
• Retirement Income Gap Calculator — See how Medicare costs fit into your overall retirement budget
• Tax Bracket Estimator — Understand how income affects your IRMAA surcharges and tax bracket