Real Numbers • Real Scenarios • Real Consequences
Medicare Supplement vs. Advantage: What Would You Actually Pay?
Choosing between a Medicare Supplement and a Medicare Advantage plan isn’t just about monthly premiums. It’s about what happens when life doesn’t go as planned.
We ran 5 real Medicare plans through 7 real-life scenarios — from a healthy year to catastrophic illness — so you can see the numbers that matter most.
No cost. No obligation. Just clarity.
Important Disclaimer
The plan details, cost estimates, and scenario outcomes presented on this page are for illustrative purposes only. While based on real plan structures, the information is not guaranteed to be 100% accurate for every fact and may not reflect current plan year benefits, formularies, or network compositions. Individual costs will vary based on your specific ZIP code, providers, prescriptions, and health status. Always validate plan details with a licensed Medicare agent before making enrollment decisions.
The One Thing Most People Don’t Understand Until It’s Too Late
Think of a Medicare Supplement as Insurance for Your Insurance
When you’re healthy, it’s easy to look at that monthly Supplement premium and think: “Why am I paying $260 a month when I barely go to the doctor?”
And that’s exactly the trap.
Because by the time you actually need a Supplement — when you’re facing a serious diagnosis, a major surgery, or a life-changing illness — you won’t be able to get one.
The Underwriting Lock-Out
Outside of your initial Medigap Open Enrollment Period, most states require you to pass medical underwriting to purchase a Medicare Supplement. That means if you’ve developed health conditions — diabetes, heart disease, cancer, COPD — an insurance company can:
The moment you need the protection most is the moment it becomes hardest — or impossible — to obtain.
A Medicare Supplement isn’t something you buy when you get sick. It’s something you secure while you’re healthy so it’s there when you need it.
The 5 Plans We Compared
Three Medicare Advantage plans and two Medicare Supplement plans — each with different trade-offs between cost, flexibility, and protection.
HMO Plan
Medicare AdvantagePPO Plan
Medicare AdvantagePPO Honor Plan
Medicare AdvantageSupplement Plan G
Medigap + Part DSupplement Plan G (High Deductible)
Medigap + Part DThe HMO Trap: Why the “Best” Plan on Paper Can Be the Most Dangerous
What Makes It Attractive
The Reality They Don’t Advertise
The $500 max out-of-pocket only protects you inside the service area. Step outside it, and that protection vanishes completely. An HMO’s coverage boundary isn’t just an inconvenience — it’s a financial cliff.
7 Real-Life Scenarios: What Would You Actually Pay?
We ran all 5 plans through 7 different medical situations — from the best case to the worst — including what happens when you need care outside your plan’s network.
Healthy Year
Age 66, healthy. Two routine doctor visits and preventive bloodwork. No health issues.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Get paid $24 | Giveback exceeds costs |
| PPO | Get paid $2,052 | Significant profit from giveback |
| PPO Honor | Get paid $2,220 | ✓ Most profit when healthy |
| Plan G | Pay $3,377 | Fixed premium + deductible |
| Plan G HD | Pay $1,080 | Just the premium |
Car Accident — Local Hospital (In-Network)
5-day hospital stay at a local in-network facility. ER visit, diagnostic tests, recovery.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Pay $476 ($500 MOOP − $24 Part B giveback) | ✓ Hits $500 MOOP — best protection |
| PPO | Pay $6,730 | Hits max out-of-pocket |
| PPO Honor | Pay $80 | Low cost due to no deductible |
| Plan G | Pay $3,377 | Same predictable cost |
| Plan G HD | Pay $1,360 | Premium + partial deductible |
Car Accident — Out of State (Out-of-Network)
Same accident, but you’re traveling. Out-of-network hospital, 5-day stay.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Pay $13,051 | 🚨 No OON coverage — you pay 100% |
| PPO | Pay $6,730 | Hits max out-of-pocket |
| PPO Honor | Pay $460 | ✓ Best OON protection among MA |
| Plan G | Pay $3,377 | Same anywhere in the U.S. |
| Plan G HD | Pay $1,360 | Same anywhere in the U.S. |
Heart Attack with Bypass Surgery — In-Network
Emergency room, bypass surgery, 7-day hospital stay, and follow-up cardiology. In-network facility.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Pay $476 ($500 MOOP − $24 Part B giveback) | ✓ $500 MOOP — unbeatable if in-network |
| PPO | Pay $6,730 | Hits max out-of-pocket |
| PPO Honor | Pay $6,880 | Near max OOP |
| Plan G | Pay $3,377 | Still just premium + deductible |
| Plan G HD | Pay $3,950 | Premium + full deductible |
Catastrophic — Advanced Cancer ($150K in Bills) — In-Network
Cancer diagnosis: surgery, 6 months of chemo, radiation, multiple hospital stays including ICU. All in-network.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Pay $476 ($500 MOOP − $24 Part B giveback) | ✓ Best catastrophic protection — in-network |
| PPO | Pay $4,678 | Protected by max OOP |
| PPO Honor | Pay $7,880 | High max OOP hurts here |
| Plan G | Pay $3,377 | Never changes — predictable |
| Plan G HD | Pay $3,950 | Maximum possible cost |
Heart Attack with Bypass Surgery — Out-of-Network
Same heart attack and bypass surgery from Scenario 4 — but you’re visiting family, on vacation, or just one county outside your plan’s service area.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Pay $80,000+ | 🚨 NO coverage outside service area — you pay the full bill |
| PPO | Pay $8,500+ | OON max out-of-pocket higher than in-network |
| PPO Honor | Pay $10,100 | Hits OON max out-of-pocket |
| Plan G | Pay $3,377 | ✓ Same cost — any hospital, any state |
| Plan G HD | Pay $3,950 | Same cost — any hospital, any state |
The HMO that costs $476 for a heart attack in-network costs $80,000+ for the exact same heart attack out-of-network. Same surgery. Same recovery. Different ZIP code.
Catastrophic Cancer ($150K) — Out-of-Network
Same advanced cancer from Scenario 5 — but you’ve relocated, you’re traveling, or the best oncologist is out-of-network. $150,000 in total medical bills at out-of-network providers.
| Plan | Annual Cost | Outcome |
|---|---|---|
| HMO | Pay $150,000+ | 🚨 FINANCIAL CATASTROPHE — zero OON coverage |
| PPO | Pay $10,000+ | OON max out-of-pocket + balance billing risk |
| PPO Honor | Pay $12,000+ | High OON max + no drug coverage |
| Plan G | Pay $3,377 | ✓ Same cost. Always. Everywhere. |
| Plan G HD | Pay $3,950 | Same cost. Always. Everywhere. |
This is the scenario that changes lives. The HMO that looked like the best deal in America — $0 premium, $500 max — can leave you responsible for $150,000 in medical bills because you received care outside the service area. The Supplement Plan G? Still $3,377. No matter what. No matter where.
The Critical Decision: Geography vs. Protection
Do You Ever Leave Your Service Area?
Can You Guarantee You’ll Stay In-Network?
The “Sweet Spot” Paradox
What the Data Shows
HMO = Best In-Network Catastrophic Protection
Unbeatable $476 max when you stay local. But $80,000–$150,000+ exposure the moment you step outside the service area. The lowest max out-of-pocket in Medicare — with the highest hidden risk.
Plan G = Best for Travelers & Certainty
$3,377 maximum annual cost — same in Miami, same in Montana, same in the ICU. Any doctor, any hospital, any state. You pay more when healthy, but your worst case is always manageable.
PPO = Best When Healthy
Get paid $2,000+/year when nothing goes wrong. But face $6,700–$10,100+ exposure when something does. Great in good years — expensive in bad ones.
Learn More
Supplement vs. Advantage
Full comparison of both coverage paths.
Supplement Plans
How Medigap works, costs, and enrollment.
Advantage Plans
How MA plans work and what to watch for.
Medicare Mistakes
Costly errors to avoid before you enroll.
Take the Quiz
Find out which path may be right for you.
Part B Giveback
Understand how giveback plans really work.
Want to See Your Numbers?
Every person’s Medicare situation is different. Let us run a comparison based on your doctors, your prescriptions, your ZIP code, and your health priorities.
Licensed independent Medicare advisor. Comparisons are provided at no cost to you.
Disclaimer: The plan names, premium amounts, cost-sharing figures, and scenario outcomes presented on this page are for illustrative purposes only and are based on a sample comparison from a specific market and plan year. Actual plan details, benefits, costs, and availability vary by ZIP code, carrier, and plan year. This content is not guaranteed to be 100% accurate for every detail and should not be relied upon as the sole basis for enrollment decisions. Always verify current plan information with a licensed Medicare agent or directly with the insurance carrier before making any Medicare enrollment changes. Eligry LLC is a licensed, independent insurance advisory firm.