Colorado Medigap vs Medicare Advantage Cost Calculator
Medicare Advantage often costs less in premiums. Medigap often costs less when you use a lot of care. Enter the premiums you were quoted and a rough idea of your usage, and this compares the two paths across a typical year and a heavy-use year.
Estimates only. Estimates only. Figures on this page use published plan-year values and the details you enter. They are not a quote, an offer of coverage, or a determination of eligibility. Your final premium and any tax credit are confirmed at enrollment with the carrier or Connect for Health Colorado. Everything is calculated in your browser; nothing you type is sent to us or anyone else.
How the two Medicare paths are costed side by side
The comparison builds a yearly total for each path from your figures, then repeats it for a year with heavy medical use. The Part B premium is left out because both paths pay it.
Both paths keep you in Medicare and both pay the Part B premium. What changes is who pays the claims and how: Medigap pays after Original Medicare, while an Advantage plan replaces Original Medicare’s claims processing with its own network rules.
- Advantage, typical year: twelve monthly premiums plus the care costs you expect, capped at the plan’s in-network maximum out-of-pocket.
- Medigap, typical year: twelve months of Plan G plus a stand-alone drug plan, plus the $283 Part B deductible, normally the only bill Plan G leaves for Medicare-approved care in 2026 (CMS).
- Advantage, heavy year: twelve premiums plus the full maximum out-of-pocket.
- Medigap, heavy year: the same as its typical year, because Plan G pays the rest of approved costs.
- Difference: which path costs less in each year, and by how much.
Advantage typical = premium × 12 + lesser of (expected care, MOOP)Medigap typical = (Plan G premium + drug plan premium) × 12 + $283Advantage heavy = premium × 12 + MOOPMedigap heavy = Medigap typical Worked example: an Adams County comparison with 2027 plan data
Hypothetical person, not a client, comparing paths for 2027. The Advantage inputs use real Adams County figures from the CMS 2027 landscape file: 30 of the county’s 36 plans have a $0 combined premium, and the median in-network maximum out-of-pocket is $6,200. The Medigap inputs are placeholders, $180 a month for Plan G and $20 for a drug plan, because Medigap rates depend on age, carrier and other factors. Use your own quotes.
With $1,500 of expected care, Advantage totals $1,500 and Medigap $2,683: Advantage is $1,183 lower.
In a heavy year Advantage rises to $6,200 while Medigap holds at $2,683. Now Medigap is $3,517 lower.
Neither total is the answer alone. The real question is which year you want protection against, and whether your doctors are in the Advantage network.
The break-even point is where expected care makes the two typical-year totals equal. Here that is $2,683 of care: below it Advantage costs less, above it Medigap does, and Advantage stops climbing at its $6,200 maximum.
| Year | Advantage | Medigap Plan G + drug plan |
|---|---|---|
| Typical year | $1,500 | $2,683 |
| Heavy-use year | $6,200 | $2,683 |
Errors that skew a Medigap versus Advantage comparison
- Comparing premiums only. A $0 premium plan still has copays up to its maximum; a heavy year changes the ranking.
- Using the in-network limit for out-of-network care. PPOs often carry a higher combined limit. If you travel or keep out-of-network doctors, model that figure.
- Leaving out the drug plan on the Medigap side. Medigap excludes prescriptions. Colorado’s 2027 stand-alone drug plans run $5.30 to $260.20 a month.
- Deciding after the Medigap window closes. The six-month Medigap Open Enrollment Period is when insurers cannot use medical underwriting to refuse you (Medicare.gov). Switching later can mean health questions.
- Overvaluing extras. Dental, vision and hearing benefits vary widely; count only what you would actually use.
- Assuming Medigap premiums stay flat. Rates usually rise with age and carrier filings. Ask each carrier about its rate history before choosing on price.
The Adams County and Colorado picture for 2027
Adams County has 36 Medicare Advantage plans for 2027 outside Special Needs Plans, from 10 carriers: 14 PPOs, 12 HMO-POS plans and 10 HMOs, with in-network maximums from $3,300 to $9,850. Weld County has 25, with maximums from $4,300 to $9,850 (CMS 2027 landscape file).
Medigap plans in Colorado are standardized: a Plan G from one carrier carries the same benefits as a Plan G from another, so price, rate history and service are what differ.
Colorado also requires Medigap to be offered to people under 65 who have Medicare because of a disability, which not every state does. Ask me or the SHIP about the details for your situation.
Colorado’s State Health Insurance Assistance Program (SHIP), run by the Colorado Division of Insurance, gives free, unbiased Medicare counseling at 888-696-7213.
Key terms: Medigap vs Advantage costs
- Maximum out-of-pocket (MOOP)
- The yearly ceiling on in-network costs for Medicare Advantage medical services.
- Plan G
- A standardized Medigap plan that pays nearly all Medicare-approved costs once you have met the Part B deductible.
- Network
- The physicians, hospitals and facilities contracted with a plan.
- Prior authorization
- Approval a plan requires before certain services, tests or procedures.
- Medical underwriting
- Health questions an insurer uses to accept, price or decline an application.
- Part B excess charges
- Amounts above the Medicare-approved rate that non-participating doctors may bill; Plan G covers them.
Information that sharpens the comparison
- Doctors, specialists and hospitals you want to keep.
- Prescriptions and your pharmacy.
- How many months a year you spend outside Colorado.
- Plan G or Plan N quotes from more than one carrier.
What this assumes
- A comparison of figures you enter. It is not a quote, and it is not a recommendation on its own.
- The heavy-use Advantage year assumes you reach the plan’s in-network maximum out-of-pocket. Out-of-network care can cost more.
- The Medigap side is modelled on Plan G: after premiums, the 2026 Part B deductible ($283) is normally the only bill for approved services.
- The Medigap path adds a stand-alone Part D premium, which the comparison includes.
- Both paths still pay the Part B premium, so it is left out of the comparison.
- Dollars are only half the decision. Networks, referrals, travel and drug coverage differ too.
Where the figures come from
- CMS 2026 Medicare Part B premium, deductible and IRMAA amounts Centers for Medicare & Medicaid Services, 2026
- CMS CY2027 Medicare Advantage and Part D landscape file (Colorado rows) Centers for Medicare & Medicaid Services, 2027
- Medicare.gov: Medigap open enrollment and medical underwriting Centers for Medicare & Medicaid Services (Medicare.gov), 2026
What this comparison cannot weigh for you
- Networks: whether your doctors and hospitals take a plan.
- Referrals and prior authorization, common in HMOs.
- Travel: Medigap follows Original Medicare nationwide, while Advantage networks are local.
- Future Medigap rate increases, which vary by carrier.
- Drug costs inside each plan.
Bring me your doctors, prescriptions and travel plans. I will check networks and price real Medigap and Advantage options for your ZIP code, so the comparison runs on actual quotes rather than placeholders.
Headwaters Health and Wealth is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 106 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Common questions
Is Medigap or Medicare Advantage cheaper in Colorado?
It depends on how much care you use. Advantage plans often have low premiums but you pay copays up to a yearly maximum. Medigap usually costs more each month but leaves few bills when you use a lot of care. This calculator compares both with your own figures.
What does Medigap Plan G leave me to pay?
For Medicare-approved services, usually just the Part B deductible: $283 in 2026. Plan G does not include drug coverage, so you add a Part D plan.
Can I switch from Medicare Advantage to Medigap later?
You can change your Medicare coverage in set periods, but outside your Medigap open enrollment a Medigap insurer can usually ask health questions and may decline you. That is why the first choice matters.
Is there a cap on drug costs in 2026?
Yes. In 2026, out-of-pocket costs for covered Part D drugs are capped at $2,100 a year, on both Part D plans and Advantage plans with drug coverage.
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Content reviewed by Lisa Asmussen, Medicare Broker and Licensed Insurance Agent at Headwaters Health and Wealth in Brighton, Colorado, certified to sell Medicare plans since 2018 (8 years). Last updated .