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Original Medicare is the government plan you join at 65: Part A for hospital stays, Part B for doctors and outpatient care. It pays most of a bill but not all of it, and — the part that surprises people — it has no yearly limit on what you can end up owing.

That gap is why almost nobody keeps it alone, and it leaves two ways forward.

Medigap (also called a supplement) is a private policy you buy alongside Original Medicare to pay the share it leaves behind. You keep any doctor in the country who takes Medicare, and you pay a monthly premium for the supplement — plus a separate drug plan, called Part D.

Medicare Advantage is the other way: one private plan replaces the lot, usually including drugs and often dental, frequently for little or no extra premium. In exchange you use the plan’s network of doctors, may need referrals, and it has its own yearly out-of-pocket limit.

Not sure which suits you? The Medicare Path Chooser ranks them against your doctors, health and travel — this calculator prices whichever you pick.

Plan G
Pays nearly everything Original Medicare leaves you owing. You pay the Part B deductible once a year, then almost nothing for covered care.
Plan N
Like Plan G but cheaper each month, in exchange for small copays at office and emergency visits, and it may not cover charges above the Medicare-approved amount.
High-deductible G
The same Plan G cover, but it only starts paying after you have met a large yearly deductible yourself. Lowest premium, highest bad-year cost.

Medigap letters are standardised by law: every insurer’s Plan G covers exactly the same things as every other insurer’s Plan G. Only the price and the company differ — so once you have picked a letter, you are shopping on price and service, not on cover.

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Income

Medicare sets 2026 premiums from your 2024 return.

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Most people pay the standard Part B premium. Above a set income, Medicare adds a surcharge — officially IRMAA — to both the Part B premium and any drug plan.

It is a cliff, not a slope. One dollar over a line moves you a whole step, and the step is charged for the entire year. Being just under a line and just over it are very different bills.

It is charged per person, not per return. Right now that means one bill — but if a spouse or partner joins Medicare later, the same income lands the same surcharge on each of you.

It looks back two years: 2026 premiums are set by your 2024 return. Income counted is adjusted gross income plus tax-exempt interest. If your income has dropped since — retiring counts — Social Security can use a more recent year via Form SSA-44.

2024 income on this returnExtra, each person
Up to $109,000
Over $109,000$96/mo
Over $137,000$240/mo
Over $171,000$385/mo
Over $205,000$530/mo
$500,000 and up$578/mo

2026 figures, published by CMS and SSA. Thresholds move most years.

Your estimate appears here

  • · Income (MAGI) on the 2024 return