$0-Premium Medicare Advantage vs. Medigap in Florida: The Real Yearly Cost Math Seniors Should Run Before December 7

A $0 monthly premium can look like the obvious bargain, until you compare the costs you might face when you need care. If your Medicare Advantage plan is ending or changing for 2027, the important question is not just, “What is the premium?” It is, “What could I pay over a full year, and can I keep seeing the doctors and hospitals I trust?”

About 3 million Floridians are enrolled in Medicare Advantage, but that does not mean all 3 million are losing coverage. Nationally, CMS reports that about 3.16 million Medicare Advantage enrollees face a plan termination or service-area reduction for 2027. Florida has 51 fewer plans in the 2027 lineup than in 2026, according to plan-count comparisons. The annual enrollment period for 2027 coverage runs October 15 through December 7, 2026.

Here is a side-by-side look at the annual cost math for a $0-premium Medicare Advantage plan and Original Medicare with Medigap Plan G and Part D.

What a $0-Premium Plan Actually Costs You

A $0-premium Medicare Advantage plan generally means you pay no additional monthly premium for the plan, not that your Medicare coverage is free. You still pay the standard Part B premium, and you may owe plan deductibles, copays, and coinsurance when you receive care.

For 2026, the standard Part B premium is $202.90 per month, or $2,434.80 for the year, and the annual Part B deductible is $283. These Part B costs apply whether you choose Medicare Advantage or Original Medicare with Medigap, so we separate them in the examples below. Higher-income beneficiaries may pay more.

A useful number to check on every Medicare Advantage plan is its maximum out-of-pocket limit (MOOP). For 2027, CMS landscape data put the median in-network MOOP for $0-premium plans at about $6,500; the average in-network MOOP is about $6,835. Medical-service deductibles averaged about $526. Actual plan costs vary by county and plan.

Remember, the MOOP is not an annual premium and is not necessarily a cap on every health expense. Check the plan’s documents for what counts toward the limit, how out-of-network care is handled, and how prescription costs are treated.

The Other Side of the Ledger: Original Medicare + Medigap + Part D

With Original Medicare, you can add a Medigap policy to help pay Medicare-approved cost-sharing and a separate Part D plan for prescription coverage. The premium is higher and more predictable; covered Medicare services generally bring less cost-sharing after you meet the Part B deductible.

For Medigap Plan G, you pay the Part B deductible yourself. After that, Plan G generally covers the Medicare-approved Part A and Part B cost-sharing covered by the policy. It does not cover prescription drugs, so you would typically choose a separate Part D plan.

Florida Plan G premiums can vary considerably. A broad illustrative range for a 65-year-old is roughly $130 to $396 per month, depending on carrier and location. Premiums can also vary based on factors such as age, gender, tobacco use, and the carrier’s pricing. Get a current quote for your county rather than relying on a statewide estimate. During a qualifying guaranteed-issue period, an insurer cannot deny coverage or charge more because of your health.

For 2026, the projected average premium for a stand-alone Part D plan is about $34.50 per month, although actual premiums differ by plan. The 2026 Part D out-of-pocket limit is $2,100 for covered drugs. For 2027, the standard Part D deductible is set at $700, with a $2,400 annual out-of-pocket cap for covered Part D drugs. These are prescription-drug figures, not medical-care cost limits. You can review Medigap basics and costs at Medicare.gov.

The Year-by-Year Math: Illustrative Examples

These examples are for comparison only. Costs vary by plan, county, prescriptions, providers, and the care you need. Both options include the same standard Part B premium, so it is shown separately.

Example A: $0-premium Medicare Advantage plan with a $6,500 in-network MOOP

• Annual plan premium beyond Part B: $0
• Potential in-network medical cost-sharing: up to $6,500, subject to the plan’s rules
• Standard Part B premium: $2,434.80 for 2026, paid separately

This is not a prediction that you will spend $6,500. In a healthy year, your out-of-pocket costs may be far lower. But if you need extensive covered medical care, your plan’s cost-sharing can add up. Prescription costs, noncovered services, and other costs may be treated separately.

Example B: Original Medicare + Plan G at an illustrative $165 per month + Part D

• Plan G premium: $165 × 12 = $1,980
• 2026 Part B deductible: $283
• Part D premium: $34.50 × 12 = $414
• Illustrative total: approximately $2,677 in Medigap and Part D premiums plus the Part B deductible
• Add the standard Part B premium paid under either option: $2,434.80
• Illustrative combined total: approximately $5,111.80, before prescription costs or other items not covered by this estimate

After the Part B deductible, Plan G generally covers Medicare-approved Part A and Part B cost-sharing covered by the policy. You still pay your Part D drug costs and any services Medicare does not cover.

The trade-off: In a normal year, Medigap may cost more in premiums than a $0-premium Medicare Advantage plan. In a high-use year, Medicare Advantage copays and coinsurance may exceed the premium difference, depending on the plan and the care you need. Compare the annual premium with the plan’s cost-sharing exposure, not the premium alone.

Networks, Doctors, and the Price of Flexibility

Original Medicare with a standard Medigap policy generally has no provider network: you can see any doctor or use any hospital nationwide that accepts Medicare. Medicare Advantage plans use plan networks, and provider participation can change.

That distinction matters during this enrollment season. Provider-network changes have affected many health systems, and UnitedHealthcare is losing its Lee Health network effective January 1, 2027. Before choosing a replacement plan, confirm directly with your doctors and preferred hospitals that they will participate in the exact 2027 plan, not just the insurance company generally.

The One-Way Door: Florida’s Medigap Switching Rules

Florida does not have an annual Medigap switching window or a birthday rule that lets you change Medigap policies every year without regard to underwriting. If you leave Medigap to try Medicare Advantage, you may not be able to get a Medigap policy back later without answering health questions and passing medical underwriting.

There is an important exception when your Medicare Advantage plan is discontinued or stops serving your area. Federal guaranteed-issue rules generally provide a window that begins 60 days before the MA coverage ends and runs through 63 days after it ends. During a qualifying window, you can apply for certain Medigap policies without medical underwriting. Which plan letters are available depends in part on when you first became eligible for Medicare; Plans C and F are generally limited to people eligible before 2020.

If you receive a termination or service-area notice, keep it and promptly confirm your exact deadline and available options. Do not assume you can try another Medicare Advantage plan and switch back to Medigap whenever you wish. Florida’s Medigap FAQ explains guaranteed-issue situations.

Which Path Fits You? A Quick Checklist

A $0-premium Medicare Advantage plan may be worth comparing if you:

• Want a lower monthly premium beyond Part B.
• Are comfortable using the plan’s network.
• Have checked your doctors, hospitals, prescriptions, and plan cost-sharing.
• Can prepare for the possibility of higher costs in a year when you need more care.

Original Medicare + Medigap + Part D may be worth comparing if you:

• Value broad access to providers who accept Medicare nationwide.
• Prefer more predictable cost-sharing for covered Medicare services.
• Can budget for monthly Medigap and Part D premiums.
• Want to understand your guaranteed-issue rights before making a change.

Use Medicare Plan Compare to check plans and formularies. For unbiased, free counseling, contact Florida SHINE at 1-800-963-5337 or visit floridashine.org. You can also call 1-800-MEDICARE (1-800-633-4227).

A brief 2027 budget note: Social Security announced a 3.6% cost-of-living adjustment on October 14, 2026. The 2027 Part B premium has not yet been officially announced; CMS typically releases it in November. The 2026 Trustees Report projects a standard premium of about $209.50 per month for 2027. A projection, not an official amount.

Talk With Borde & Associates in Melbourne

Borde & Associates has proudly served Melbourne and nearby communities for over a decade. If you want help comparing your options, our team can walk through the premiums, provider access, prescription coverage, and switching deadlines with you.

Explore our Medicare options, insurance and retirement solutions, and short- and long-term care resources, or contact our Melbourne team to request a consultation.

We don't offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

This article was created by AI.

Frequently Asked Questions

Is a $0-premium Medicare Advantage plan really free?

No. You generally still pay the Part B premium and may owe deductibles, copays, or coinsurance when you receive care. Check the plan’s MOOP and what expenses count toward it.

What is the 2026 standard Medicare Part B premium?

The standard Part B premium is $202.90 per month in 2026, or $2,434.80 for the year. The 2026 Part B deductible is $283. Higher-income beneficiaries may pay more. CMS published the 2026 figures here.

Does Medigap Plan G cover the Part B deductible?

No. Plan G generally covers Medicare-approved Part A and Part B cost-sharing included in the policy after you meet the Part B deductible. You also need separate prescription drug coverage if you want Part D.

Can I switch from Medicare Advantage to Medigap in Florida without underwriting?

It depends on your circumstances. If your plan is discontinued or stops serving your area, you may have a limited guaranteed-issue period. Florida does not have a general annual Medigap switching window, so confirm your specific eligibility and deadline before changing coverage.

What is the 2027 Part B premium?

As of October 16, 2026, CMS has not announced the official 2027 standard Part B premium. The projected figure of about $209.50 per month is an estimate from the 2026 Trustees Report, not a final amount.

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