Medicare Advantage Cost Comparison: The 6 Numbers That Decide It

Choosing between a Medicare Advantage plan and your FEHB coverage comes down to arithmetic — and most retirees run it on two numbers when it takes six.

The short answer: A complete Medicare Advantage cost comparison adds four figures on each side: the premiums you pay, the plan’s annual out-of-pocket cap, the cost-sharing you expect, and any Part B premium the plan gives back. Premiums alone hide the numbers that decide the outcome.

What are the key takeaways?

• The standard Medicare Part B premium is $202.90 a month in 2026, with a $283 annual deductible, according to Medicare.gov.
• OPM states that enrolling in Medicare does not change your FEHB premium. Keeping both means paying both.
• Many Medicare Advantage plans accessed through an FEHB plan reimburse some or all of the Part B premium, which is the single largest swing factor in the comparison.
• The average FEHB enrollee share rose 10.9% for 2027, so last year’s comparison is already out of date.

What belongs in a Medicare Advantage cost comparison?

Four lines per route, not one. On the FEHB side: your annual enrollee premium, the Part B premium, expected cost-sharing, and your plan’s catastrophic limit. On the Medicare Advantage side: the plan premium, the Part B premium, expected copays, and the in-network maximum out-of-pocket. Every Medicare Advantage plan publishes that cap. Every FEHB brochure publishes its own. Those two caps are what a premium-only comparison leaves out.

Add a fifth line where it applies: OPM notes many Medicare Advantage plans offered through FEHB reimburse part or all of the Part B premium. A $100 monthly giveback is $1,200 a year and can reverse the result on its own.

How do the numbers look for a self-only retiree in 2026?

Suppose your self-only FEHB enrollee share is $250 a month; check your own brochure, since shares vary widely.

• Keep FEHB and Part B: $3,000 FEHB + $2,434.80 Part B = $5,434.80 in premiums before a single appointment.
• Suspend FEHB for a $0-premium Medicare Advantage plan: $0 plan premium + $2,434.80 Part B = $2,434.80.

That $3,000 gap is where the comparison usually stops. Now finish it. Under the first route, many FEHB plans waive deductibles and copays once Medicare pays first. Expected cost-sharing may be close to zero. Under the second, you pay copays until you hit the plan’s out-of-pocket cap. That cap can run into five figures. A low-utilization year favors the second line; a hospitalization year can erase the gap. Run both at your own expected usage, not at zero.

Which costs do federal retirees leave out of the math?

Three, usually. First, income-related surcharges. OPM notes the government normally pays 75% of the Part B premium. For higher-income beneficiaries that subsidy falls to between 65% and 15%, so your Part B line can be larger than the standard figure. Second, drug coverage — compare it directly rather than assuming parity, and see our post on Medicare Part D for FEHB retirees. Third, reversibility. OPM says suspending FEHB keeps your right to re-enroll at Open Season or a qualifying life event. Canceling as an annuitant is permanent.

For how suspension works and the trade-offs beyond cost, see the parent guide: Should you drop FEHB for Medicare Advantage in retirement? If you delayed Part B, add the Part B late enrollment penalty to every year of the comparison. It is permanent.

What else do federal retirees ask about a Medicare Advantage cost comparison?

Does a Medicare Advantage cost comparison change if I stay in FEHB? Yes. OPM offers Medicare Advantage plans through FEHB plans, and electing one does not require suspending FEHB.

Do I still pay Part B either way? You must have Part A and Part B to join a Medicare Advantage plan, so the Part B premium appears on both sides of the comparison.

How often should I redo it? Every Open Season — premiums, caps and givebacks reset each plan year.

Where do the official numbers come from? Part B figures from CMS; FEHB premiums and suspension rules from OPM.

Want help running your own numbers? Fed Pilot holds free federal retirement benefits workshops. Register for an upcoming session.