Original Medicare vs Medicare Advantage: A Side-by-Side Cost Comparison for 2026

Each fall, many people face the same choice. Stay with Original Medicare, or join a Medicare Advantage plan? Both cover hospital and doctor care. They charge you in very different ways. Original Medicare uses set national costs that this guide can state in full. A Medicare Advantage plan sets its own copays, and those change from plan to plan. This guide lays the two routes side by side so you can see where the money goes. Our Medicare Advantage section holds more guides on plan rules and windows.

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The costs you pay in both routes

The Part B premium is $202.90 a month in 2026 (Ledger A1). Almost all people pay it in both routes. If you join an Advantage plan, you still pay it. Some plans pay part of it back, but that is a plan perk, not the base rule.

Drug cover is a cost in both routes too. With Original Medicare, you join a separate drug plan if you want drug cover. With an Advantage plan, drug cover is often built in. In both cases, check the drugs you take against the plan list before you join.

Original Medicare costs, line by line

• Premium: $202.90 a month for Part B (Ledger A1). Most people pay no premium for Part A.
• Part B deductible: $283 for the year (Ledger A2). You pay this before Medicare pays its share for most doctor care.
• Doctor and clinic care: after the deductible, you pay 20% of the approved amount for most care (Ledger A16). There is no yearly cap on that 20% under Original Medicare on its own.
• Hospital stays: you pay a deductible of $1,736 per benefit period (Ledger A6). A benefit period is not a calendar year. A new one can start in the same year after a break in care.
• Skilled nursing care: days 1 to 20 cost $0. Days 21 to 100 cost $217.00 a day (Ledger A8). After day 100, Medicare pays nothing for that stay.
• Extra cover: you can buy a Medigap policy to help with the 20% share and other gaps. That adds a premium set by the company that sells the policy.

Medicare Advantage costs, line by line

Our guide on the Medicare Advantage out-of-pocket maximum explains what counts toward a plan limit and what does not.

• Premium: you keep paying the $202.90 Part B premium (Ledger A1). The plan may add a premium of its own, or it may charge none. That amount is set by the plan.
• Doctor and clinic care: the plan sets copays or a share of the cost for each service. A visit to your main doctor and a visit to a specialist often cost a different amount.
• Hospital stays: the plan sets its own cost, often a set amount per day for the first days of a stay. It is not the $1,736 deductible (Ledger A6). That figure belongs to Original Medicare only.
• Yearly limit: each plan sets a yearly limit on what you pay for covered Part A and Part B care. When you reach it, the plan pays the full cost of covered care for the rest of the year. The limit amount is plan-specific. This guide states no dollar amount for it, since no one amount fits all plans.
• Network rules: most plans pay less, or pay nothing, for care outside the plan network, except in an emergency. Original Medicare has no network of this kind.
• Extra perks: many plans add things Original Medicare does not cover, such as some dental, vision, or hearing help. The value of those perks rests on how much you use them.

Who pays for what

• Original Medicare pays its share of covered care first: 80% of the approved amount for most Part B care after the deductible (Ledger A16), and its share of hospital costs after the $1,736 deductible (Ledger A6).
• A Medicare Advantage plan is paid by Medicare to cover its members. While you are a member, the plan pays for your covered care under its copays, rules, and yearly limit.
• A Medigap policy pays toward your share of Original Medicare costs. It does not work with a Medicare Advantage plan.
• Medicaid can help some people with premiums and costs if they qualify through their state.
• Private pay covers the rest: premiums, deductibles, copays, and any care your cover does not pay for.

Sample situation

Ann is 70 and needs a knee operation in 2026. She compares her two routes. On Original Medicare, she would pay the $283 Part B deductible (Ledger A2), then 20% of the approved amount for the surgeon and follow-up care (Ledger A16). Her hospital stay would start with the $1,736 deductible (Ledger A6). On the Advantage plan she was offered, the hospital cost is a set daily copay set by that plan, and her yearly costs stop at that plan's own limit. Ann adds up the care she knows she will use. She picks the route with the lower total for her own care, not the route with the lower premium alone.

How to run your own side-by-side count

Our guide on switching back to Original Medicare and trial rights explains the right some people hold in their first year if a plan turns out to be a poor fit.

• List the care you used this year: doctors, hospital stays, tests, and drugs.
• Price that same care under each route. Use the set 2026 figures above for Original Medicare. Use the plan's own cost summary for an Advantage plan.
• Add the premiums for a full year in each route.
• Check your doctors and your drugs in each route before you trust the total.
• Note the worst case in each route: no cap on the 20% share in Original Medicare on its own, versus the plan's own yearly limit in an Advantage plan.