REAL-LIFE COST COMPARISON
Comparing Stroke Costs: Medicare Supplement vs. Medicare Advantage
We asked healthcare experts to estimate the average cost of having a stroke in Illinois, then compared what that would look like under two types of UnitedHealthcare coverage: a Medicare Supplement Plan and a Medicare Advantage Plan with a maximum out-of-pocket (MOOP) limit of $2,900.
Keep in mind — a $2,900 MOOP is exceptionally low. Most Medicare Advantage plans today have a maximum out-of-pocket between $5,000 and $10,100.
When you’re comparing Advantage Plans, always pay close attention to the MOOP. It represents the most you could pay out of pocket for covered medical services in a given year.
In our example, if the Advantage Plan you’re considering has a $7,500 MOOP (which is fairly typical), you’d need to add about $4,600 to the Advantage Plan’s stroke cost to make a realistic comparison.
Stroke Treatment Cost Analysis
Illinois Medicare Coverage Comparison 2025-2026
Click to download a printable PDF of this analysis
Average Stroke Treatment Costs in Illinois
Total Estimated Average Cost: $20,000 - $45,000+
| Cost Component | Details |
|---|---|
| 1. Ambulance Transport |
• ALS: $0-$1,900 (residents), $433-$2,587 (non-residents) • BLS: $587 (residents), $732 (non-residents) • With insurance: $50-$500 out-of-pocket |
| 2. Hospital Stay |
• Average total: $20,396 - $43,652 • Per day average: $3,025 • Median cost: $4,408 |
| 3. Intensive Care Unit |
• Day 1: $6,667 - $10,794 • Days 2-3: $3,496 - $4,796 • Day 3+: $3,184 - $3,968 per day |
| 4. Radiology/Imaging |
• 19% of total hospital costs • CT scans, MRI, CT angiography • 91% of stroke patients need imaging |
| 5. Room Charges | 50% of total hospitalization costs |
| 6. Medical Management |
• 21% of total hospital costs • Medications: $5,000+ in first year |
| 7. Nursing Care | 63% of daily care costs (included in room charges) |
| 8. Rehabilitation |
• Acute phase: 7% of hospital costs • First year therapy: $11,000+ |
| 9. Physician/Surgeon Fees | ER physicians, neurologists, surgeons (billed separately) |
| 10. Laboratory Tests | Blood work, coagulation studies, cardiac enzymes |
Includes hospital stay, rehab, therapy, medications, and follow-up care
Medicare Coverage Basics
| Coverage Item | Medicare Part A | Medicare Part B |
|---|---|---|
| Deductible (2025) | $1,676 (first 60 days) | $240 annually |
| SNF Coverage | Days 1-20: $0 Days 21-100: $209.50/day |
N/A |
| Therapy Coverage | N/A | 80% covered, you pay 20% |
Plan Comparison: Stroke Scenarios
Scenario 1: Typical Stroke (6-day hospital stay)
AARP Medicare Advantage IL-8
| Ambulance (ground) | $275 |
| Emergency room | $0 |
| Hospital (6 days @ $295) | $1,770 |
| CT/MRI scans (2 @ $260) | $520 |
| Lab tests | $0 |
| Diagnostic procedures | $50 |
| Acute rehab (3 sessions) | $90 |
| Medical Out-of-Pocket | $2,705 |
| Annual premiums | $0 |
| YEAR 1 TOTAL | $2,705 |
Medigap Plan G
| Monthly premium ($191.55 × 12) | $2,298.60 |
| Part B deductible | $240 |
| Ambulance | $0 |
| Hospital Part A deductible | $0 |
| All other copays/coinsurance | $0 |
| CT/MRI scans | $0 |
| Lab tests | $0 |
| Rehab therapy | $0 |
| YEAR 1 TOTAL | $2,538.60 |
Scenario 2: With Skilled Nursing Facility (SNF days 21-30)
| Cost Item | Medicare Advantage | Medigap Plan G |
|---|---|---|
| Hospital costs (from Scenario 1) | $2,705 | Covered in premiums |
| SNF days 21-30 ($218/day) | Capped by max OOP | $0 |
| Maximum out-of-pocket cap | $2,900 | N/A |
| Annual premiums | $0 | $2,298.60 |
| Part B deductible | N/A | $240 |
| YEAR 1 TOTAL COST | $2,900 | $2,538.60 |
Scenario 3: Severe Stroke (Extended hospital + SNF + extensive therapy)
| Cost Item | Medicare Advantage | Medigap Plan G |
|---|---|---|
| No matter how high costs go... | Capped | All covered |
| Maximum out-of-pocket | $2,900 | — |
| Annual premiums | $0 | $2,298.60 |
| Part B deductible | N/A | $240 |
| All other costs | Covered by cap | $0 |
| YEAR 1 TOTAL COST | $2,900 | $2,538.60 |
Ongoing Therapy Costs (Months 2-12)
| Plan | Therapy Costs | Example (40 visits) |
|---|---|---|
| Medicare Advantage IL-8 | $30 per PT/OT visit | $1,200 total (but counts toward $2,900 max OOP) |
| Medigap Plan G | $0 (covers 20% coinsurance) | $0 (after Part B deductible already paid) |
Key Differences Summary
| Factor | Medicare Advantage IL-8 | Medigap Plan G |
|---|---|---|
| Monthly Premium | $0 | $191.55 |
| Annual Premium | $0 | $2,298.60 |
| Maximum Out-of-Pocket | $2,900 | $2,538.60* |
| Network Restrictions | YES - must use network | NO - any Medicare provider |
| Referrals Needed | YES - for specialists | NO |
| Cost Predictability | Capped but copays add up | Very predictable |
| Best For | Healthy years, routine care | Peace of mind, serious illness |
Bottom Line Conclusions
For Stroke Treatment in Illinois:
- Medigap Plan G is likely CHEAPER by $166-$361, despite higher premiums
- Plan G offers better financial protection - you know exactly what you'll pay ($2,538.60 maximum)
- Plan G offers complete freedom - any doctor, any hospital, no referrals needed
- Medicare Advantage cap protects you if costs exceed $2,900, but Plan G protects you better at $2,538.60
Critical Advantage of Plan G for Stroke:
No network restrictions means you can see top neurologists and stroke specialists at any hospital without worrying about in-network status during an emergency. Time is critical in stroke treatment - every minute counts, and you don't want network concerns delaying care.
- Costs vary significantly based on stroke severity and complications
- These figures represent averages for Illinois in 2025-2026
- Individual cases can be much higher or lower
- Plan G premium of $191.55/month is locked in and predictable
- Medicare Advantage costs can change annually