Blog / Medicare Advantage

How much does a Medicare Advantage plan cost?

The premium is the smallest part of the answer. Here is every cost an Advantage plan can carry and how to compare two plans honestly.

Updated August 17, 2026 · 3 min read

Advantage plans are usually described by their monthly premium, which is the least useful number for predicting what you will actually spend.

What you always pay

Your Part B premium, every month, no matter what plan you choose. Advantage does not replace it. That is the floor under every Advantage plan.

If your income is above the IRMAA threshold, you pay that surcharge too. See how IRMAA works.

The plan premium

This is the plan's own monthly charge on top of Part B. Many plans in this area carry none. That does not make them free, it means their costs reach you as copays instead.

Some plans go further and credit money back toward your Part B premium. See how giveback plans work.

The costs that actually vary

• Copays for primary care and specialist visits
• A daily copay for inpatient hospital stays, often for the first several days of an admission
• Copays or coinsurance for imaging, outpatient surgery, ambulance and therapy
• Drug costs under the plan's formulary, with its own deductible and tiers
• Coinsurance on some higher cost services, meaning a percentage rather than a flat copay

Coinsurance is worth watching. A flat copay is predictable. A percentage of a large bill is not.

The out of pocket maximum

Every Advantage plan caps what you can pay for covered in network services in a year. Once you reach it, the plan covers everything else.

That cap is the most important number on the whole plan, more than the premium, because it defines your worst case. PPO plans usually have two: a lower one for in network care and a higher combined one that includes out of network.

How to compare two plans properly

1. Write down the annual out of pocket maximum for each. That is the worst case.
2. Add twelve months of plan premium to each.
3. Price your actual medications on each plan's formulary at your actual pharmacy. This is where plans differ most and where people lose the most money.
4. Check whether your doctors and your hospital are in network for that specific plan.
5. Only then compare the extra benefits, and value them in dollars rather than as a list.

Help with the costs

Extra Help reduces prescription costs substantially for people under certain income limits. Medicare Savings Programs can pay your Part B premium outright, which is real money back in your Social Security check every month.

Both are underused here. It costs nothing to check. See how these programs work in Texas.

Why we do not publish plan numbers here

Specific premiums, copays and benefit amounts vary by plan and change every year, and CMS regulates how agencies present plan specific figures. Rather than post numbers that are wrong by January, we will walk through the actual plans available at your address and price them against your own medications and doctors.