I take several medications, including Mounjaro and Jardiance, and am comfortable with network restrictions. Which costs less overall: $0-premium Medicare Advantage with drug coverage or Medigap plus Part D?

Question

Caroline Johnson · Accepted Answer

Short version: with drugs like Mounjaro and Jardiance, your drug costs will probably be close to the same either way, so the real decision comes down to premiums versus how much medical care you use.

Drugs: close to a tie

Starting in 2027, every Part D plan caps what you pay for covered drugs at $2,400 for the year. That includes the drug coverage inside a Medicare Advantage plan and a standalone Part D plan you’d pair with a Medigap. Mounjaro alone is expensive enough that most people on it hit that cap early in the year. Either way, expect about $2,400 in drug costs, plus any Part D premium if you go the Medigap route. Jardiance is one of the drugs with a Medicare-negotiated price, which helps on any plan. If paying $2,400 up front is hard, the Medicare Prescription Payment Plan spreads it out over monthly payments.

Medical: where the plans really differ

$0-premium Medicare Advantage: You pay copays as you use care. The federal cap for 2027 is $9,850 in-network, and many plans set theirs lower. If you’re fairly healthy, you could spend very little. In a bad year, you pay up to your plan’s limit.

Medigap (usually Plan G) + Part D: You pay a monthly premium for the supplement plus the drug plan. In return, your medical costs are close to zero after the Part B deductible. This costs more in a light year and less in a heavy year, and you can see any provider who takes Medicare.

The quick math

Add up a year of Medigap and Part D premiums. Compare that number to the Advantage plan’s out-of-pocket maximum. If you rarely see doctors beyond routine diabetes care, Advantage usually costs less overall. If you expect hospital stays, procedures, or a lot of specialist visits, Medigap often comes out ahead.

Mary Alice Williford · Answer

A $0-premium Medicare Advantage plan may cost less overall if you are comfortable with its network and both Mounjaro and Jardiance are covered at a reasonable cost. But I encourage all to compare the plan’s drug costs, prior-authorization rules, pharmacy network, and annual medical out-of-pocket maximum, not just the $0 premium. While Medigap plus Part D offers broader provider access and more predictable monthly expenses, it usually costs more each month.

Answered by Mary Alice Williford on November 2, 2026

Broker Licensed in NC

Answered by Mary Alice Williford Medicare Insurance Agent

Charles Garrett · Answer

Since you are comfortable with provider networks I would start by comparing $0 premium MAPD PPO and HMO plans. I would not necessarily go for the least expensive premium. Look for the one that covers both Mounjaro and Jardiance. One that has reasonable copays and coinsurance and a manageable out of pocket maximum. Also make sure that the doctors and hospitals you want to see are in network.

Answered by Charles Garrett on November 3, 2026

Agent Licensed in SC

Answered by Charles Garrett Medicare Insurance Agent

Alisa Ugalde · Answer

It comes down to how much care they use - lighter use, Advantage usually costs less overall; heavy or expected care, Medigap's flat predictability often wins and never surprises.

Ira Smith · Answer

Medigap plus Part D costs you much less than a Medicare Advantage Plan, regardless of whether you select a $0 premium plan or one that has a very low premium like $35. Only if you have a history of lots of hospitalizations will Medigap plus Part D be better for you. I'll be happy to help. Thanks so much, Ira

Answered by Ira Smith on November 3, 2026

Agent Licensed in OK

Answered by Ira Smith Medicare Insurance Agent

I take several medications, including Mounjaro and Jardiance, and am comfortable with network restrictions. Which costs less overall: $0-premium Medicare Advantage with drug coverage or Medigap plus Part D?

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I take several medications, including Mounjaro and Jardiance, and am comfortable with network restrictions. Which costs less overall: $0-premium Medicare Advantage with drug coverage or Medigap plus Part D?

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