Medicare Advantage vs Medigap Cost Calculator, 2027 Open Enrollment Comparison (Excel)

A Medicare Advantage plan with a zero premium and a Medigap policy at 180 a month are not two prices for the same thing.

One takes the money up front and asks for almost nothing when you use care. The other takes nothing up front and charges you every single time you walk through a door. Nobody can compare those two shapes in their head, and premium against premium - which is how almost every comparison is laid out - is the one comparison that cannot answer it.

This spreadsheet adds up the whole year instead, for up to four options at once: the premiums, what the care costs you at the point of use, and what your own prescriptions cost under each plan's drug benefit.

And it gives you three answers, because nobody knows which kind of year they are about to have:

- a LIGHT year: check-ups, routine bloods, your usual prescriptions
- an EXPECTED year: what you honestly think will happen
- a BAD year: a hospital admission, rehabilitation, a specialist you did not plan for

The cheapest option is frequently a different one in each. Seeing all three side by side is the entire point.

* WHAT IT WORKS OUT

For every option and every scenario:

premiums for the year = 12 x (Part B premium - any Advantage giveback + Part B IRMAA + Medigap + plan premium + Part D premium + Part D IRMAA)
what care costs you = every service count x what YOU pay for it under that option, plus the Part B deductible if that option leaves you paying it
capped = the line above, limited to that option's annual out-of-pocket maximum - and an option with no maximum is shown as having none
medicines = that plan's Part D deductible + your cost per fill x fills per year, capped at the annual Part D out-of-pocket limit

TRUE ANNUAL COST = premiums + capped care + medicines

* THE NUMBER NOBODY IS EVER SHOWN

Every option also gets a worst case: twelve premiums, plus the full medical out-of-pocket maximum, plus the full Part D limit. It is the only figure in the comparison that is not a guess about how much care you will use, and it is the one to decide on when two options are close.

Original Medicare on its own has no such ceiling at all. The file says so, in plain words, in the cell.

* WHAT IS ON EACH TAB

START HERE - what the file answers, what to have in front of you, and exactly how the maths is done, so you can check it.
Setup - eight answers everything else follows from: the Part B premium, both IRMAA surcharges, the Part B deductible and the Part D annual out-of-pocket limit.
Your Options - four options, one row each. Medigap premium, plan premium, standalone Part D premium, any Part B giveback, the annual out-of-pocket maximum and the star rating, with checks that flag an Advantage plan entered without its maximum.
Expected Care - twelve kinds of care with a count and a typical charge, in three columns: a light year, the year you expect, and a bad one. Each line says whether it counts toward an out-of-pocket maximum, because routine dental, vision and hearing never do.
What You Pay - the grid that decides the answer. What one visit, one day or one trip costs YOU under each option, with a guide to what to type for Plan G, Plan N, high-deductible Plan G and a Medicare Advantage plan.
Your Medicines - sixteen prescriptions, fills per year, and your cost per fill under each plan, plus that plan's Part D deductible and whether you reach the annual limit.
True Annual Cost - three scenario blocks, four options, one number each, with the cheapest named and the gap to the next one.
Dashboard - the best option in each kind of year, whether the same one wins all three, the cost of choosing wrong in an ordinary year, and the worst case for every option.
Enrolment & Decision - every enrolment window with what it lets you change, a countdown to your own deadline, what you decided and why, and eight things to confirm before you enrol.
Reference Figures - the published numbers, each with the year it belongs to and where it came from: Part D for 2027, Parts A and B for 2026, the IRMAA brackets, and what each Medigap policy actually leaves you paying.

* THE FIGURES ARE DATED, AND THAT IS DELIBERATE

The 2027 Part D figures are already final and are built in: a standard deductible of at most 700, and a hard annual out-of-pocket limit of 2,400 on covered drugs, both from the CMS Contract Year 2027 Rate Announcement.

The 2027 Part B premium and the 2027 IRMAA brackets are not published until around the middle of November 2026. So the file ships with the 2026 figures, every row says which year it is from, and every one of them is a cell you can type over. When your own Annual Notice of Change arrives, or when the new figures are announced, you retype them once on the Setup tab and everything else follows. Nothing in this file is a prediction.

* HOW IT WORKS

Open it in Excel, or upload it to Google Drive and open it with Google Sheets. Copy the numbers off your Annual Notice of Change - which must reach you by 30 September - and off the Medicare Plan Finder at medicare.gov, which will also tell you what each of your own medicines costs per fill under each plan at your own pharmacy.

About forty minutes, once a year. No account to make, no subscription, no app for anyone to download. Nothing you type leaves your computer.

* WHAT YOU GET

One .xlsx file with all ten tabs, instantly downloadable after purchase. Works in Microsoft Excel 2007 or newer, and in Google Sheets with a free Google account. Nothing physical is shipped.

* PLEASE READ

This is a personal decision-making tool, not insurance advice, tax advice, legal advice or medical advice. It is not affiliated with, endorsed by or connected to Medicare, CMS or any government agency, and it is not a substitute for a licensed insurance agent or a State Health Insurance Assistance Program counsellor. It contains no plan database and no insurer's premiums - every figure it produces is arithmetic on numbers you type in yourself. A plan's own documents, the Evidence of Coverage, the Summary of Benefits and the Annual Notice of Change, always override anything shown here. Confirm the figures with the plan and with medicare.gov before you enrol, and never miss an enrolment deadline on the strength of a spreadsheet.

Because this is an instant digital download, it cannot be returned. If something does not work, message me and I will fix it.

P.S. - Also grab our FREE Mini Budget Tracker spreadsheet: https://neattrailco.com

- NeatTrailCo · Simple templates for a tidier, calmer life ✨