Medicare Cost Calculator

Q: Should I choose Medigap or Medicare Advantage?

Original Medicare + Medigap offers widest provider access (93% of doctors), no referrals, nationwide coverage, and predictable costs but higher premiums. Medicare Advantage has lower premiums and often includes dental/vision/hearing but restricts you to a network and may require prior authorizations. Choose Medigap if you travel, have complex health needs, or want flexibility. Choose MA if you're healthy and cost-conscious.

Q: When should I enroll in Medicare to avoid penalties?

Your Initial Enrollment Period is 7 months around your 65th birthday. Missing it means: Part B carries a permanent 10% penalty per 12-month period of delayed enrollment. Part D has a 1% per month penalty for gaps without creditable coverage. Exception: employer coverage through a current employer lets you delay without penalty using a Special Enrollment Period.

Q: What does Medigap Plan G vs Plan N cover?

Plan G is the most comprehensive Medigap plan for new enrollees, covering Part A deductible ($1,736), Part B coinsurance (20%), skilled nursing coinsurance, and foreign travel emergencies. You only pay the $283/year Part B deductible. Plan N is similar but requires a $20 office visit copay and $50 ER copay (if not admitted), with premiums typically $40-$80/month less than Plan G.

Q: How can I reduce my IRMAA surcharges?

Strategies include: Roth conversions before age 65 to reduce future MAGI, managing capital gains through tax-loss harvesting, Qualified Charitable Distributions (up to $105,000 from IRA), and filing SSA-44 if you've retired or had a life-changing event so Social Security uses current-year income instead of the 2-year lookback. Note that tax-exempt municipal bond interest IS included in MAGI for IRMAA.

Calculate your total Medicare premiums for 2026 including Parts A, B, and D with IRMAA surcharges. Compare Original Medicare + Medigap vs Medicare Advantage, and project your lifetime Medicare spending through retirement.

Calculate your total monthly Medicare premiums including IRMAA surcharges

Your age

Medicare eligibility starts at 65

MAGI (2 years prior)

Modified Adjusted Gross Income from 2024 tax return

Filing status

Determines IRMAA income thresholds

Part A premium status

Based on quarters of Medicare-taxed employment

Part D plan premium

Varies by plan. National average ~$39/mo (CMS)

Medigap plan

Supplemental insurance. Premiums vary by state/age

Dental/vision rider

Monthly cost for supplemental dental/vision

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How to Use This Calculator

Monthly Medicare Cost tab

The default tab. Enter your age, MAGI from 2 years prior (2024 income for 2026 premiums), and filing status. The calculator shows your Part A premium, Part B premium with any IRMAA surcharges, Part D premium, optional Medigap coverage, and dental/vision riders. Expand "More options" to adjust Part A status, Part D plan premium, Medigap plan, and dental/vision costs.

Medigap vs Advantage tab

Compare Original Medicare + Medigap Plan G vs a Medicare Advantage plan based on your expected healthcare usage. Enter your doctor visits, hospitalizations, prescriptions, network preferences, and travel habits. See total annual cost for each path, out-of-pocket estimates, and which option saves more. Medicare Advantage has a $8,850 out-of-pocket maximum; Original Medicare has no cap without Medigap.

Lifetime Projection tab

Project your cumulative Medicare spending from age 65 through your expected lifespan. Factor in medical cost inflation (default 5.5%), MAGI growth (which may push you into higher IRMAA brackets), and compare to employer-sponsored insurance costs. See milestones every 5 years and total lifetime spending.

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The Formula

Medicare costs combine premiums, deductibles, and coinsurance across multiple parts:

Monthly Premium = Part A + Part B (+ IRMAA) + Part D (+ IRMAA) + Medigap + Riders

Part B IRMAA Surcharge = based on MAGI from 2 years prior and filing status
Part D IRMAA Surcharge = based on same MAGI brackets

Annual Cost = Monthly Premium × 12 + Part A Deductible + Part B Deductible
Part B Out-of-Pocket = 20% of Medicare-approved charges after $283 deductible

Lifetime Cost = ∑ (Annual Cost_year × (1 + inflation rate)^year)

Most Medicare beneficiaries pay $0 for Part A (40+ quarters of work history) and the standard $202.90/month for Part B in 2026. Higher earners face IRMAA surcharges that can add hundreds per month. Medigap plans cover the 20% Part B coinsurance gap, providing predictable costs at the expense of higher premiums.

The IRMAA look-back period uses your tax return from 2 years prior — so 2024 income determines your 2026 surcharges. You can appeal through form SSA-44 if you experienced a life-changing event (retirement, divorce, death of spouse).

Example

Margaret — recently retired at 65 with $150K MAGI

Margaret retired in 2025 at age 65. Her 2024 MAGI was $150,000 (single filer) from her final year of employment. She has 40+ quarters of work history, chooses Medigap Plan G, and a Part D plan at $39/month.

Monthly Medicare Cost tab

Part A premium$0/mo

Part B premium (base)$202.90/mo

Part B IRMAA surcharge+$202.10/mo

Part D premium$39/mo

Part D IRMAA surcharge+$35.30/mo

Medigap Plan G$200/mo

Total monthly premium$679/mo

Total annual cost$8,149/yr

Margaret pays $679/month in total premiums. Her IRMAA surcharges add $237.40/month ($2,849/year). Once she retires and her MAGI drops, she can file SSA-44 to remove surcharges, potentially saving over $2,800/year.

Medigap vs Advantage tab

Original Medicare + Medigap annual cost$7,917

Medicare Advantage annual cost$5,120

MA saves (with 8 visits, 0 hospitalizations)$2,797/yr

With low healthcare usage, Medicare Advantage is cheaper. But Margaret travels frequently and wants any doctor — so she chooses Original Medicare + Medigap for flexibility and predictability.

FAQ

What is IRMAA and how does it affect my Medicare premiums? ▼

IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge added to your Part B and Part D premiums if your Modified Adjusted Gross Income exceeds certain thresholds. In 2026, single filers with MAGI above $106,000 (or $212,000 for married filing jointly) pay higher premiums. The surcharges range from $74–$444/month for Part B and $12.90–$81/month for Part D. IRMAA is based on your income from 2 years prior (2024 for 2026 premiums). You can appeal through SSA form SSA-44 if you’ve had a life-changing event like retirement.

Should I choose Medigap or Medicare Advantage? ▼

It depends on your priorities. Original Medicare + Medigap offers the widest provider access (93% of doctors accept Medicare), no referral requirements, nationwide coverage, and predictable costs — but higher premiums. Medicare Advantage has lower premiums and often includes dental, vision, and hearing — but restricts you to a network, may require prior authorizations, and may not cover care outside your service area. If you travel frequently, have complex health needs, or want maximum flexibility, Medigap is usually better. If you’re healthy and cost-conscious, Medicare Advantage can save money.

When should I enroll in Medicare to avoid penalties? ▼

Your Initial Enrollment Period (IEP) is 7 months: 3 months before your 65th birthday, your birthday month, and 3 months after. If you miss this window: Part A has no penalty if you qualify for premium-free coverage. Part B carries a 10% penalty for each 12-month period you were eligible but didn’t enroll — this penalty is permanent. Part D has a 1% penalty per month you went without creditable coverage. Exception: if you have employer coverage through your or your spouse’s current employer, you can delay enrollment without penalty and use a Special Enrollment Period when that coverage ends.

What does Medigap Plan G vs Plan N cover? ▼

Plan G is the most comprehensive Medigap plan available to new enrollees (Plan F closed to new enrollees after 2020). Plan G covers the Part A deductible ($1,736), Part B coinsurance (20%), skilled nursing coinsurance, Part A hospice coinsurance, and foreign travel emergencies. The only cost you pay is the Part B deductible ($283/year). Plan N covers nearly the same but requires a $20 copay for office visits and a $50 copay for ER visits that don’t result in admission. Plan N premiums are typically $40–$80/month less than Plan G.

How can I reduce my IRMAA surcharges? ▼

Strategies to reduce IRMAA: (1) Roth conversions before 65 — pay taxes now at lower brackets to avoid higher MAGI later. (2) Manage capital gains — harvest losses, use tax-lot accounting, hold positions longer to control realized gains. (3) Municipal bond income — note that tax-exempt interest IS included in MAGI for IRMAA purposes. (4) QCDs (Qualified Charitable Distributions) — donate up to $105,000 directly from your IRA to charity; this reduces your AGI. (5) File SSA-44 if you’ve retired, divorced, or experienced a life-changing event — Social Security will use your current-year income instead of the 2-year lookback.

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