Medicare Advantage Out-of-Pocket Calculator
Estimate annual Medicare Advantage premiums and medical out-of-pocket spending.
Last updated: October 15, 2026
Estimated annual plan cost
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- Medical out-of-pocket estimate: —
- Annual plan premiums: —
- Amount limited by the plan maximum: —
On this page
Quick summary: Estimate annual Medicare Advantage premiums and medical out-of-pocket spending.
Read the method, example and limitations
Updated reference sections in this guide are in English.
Guide language: English. Updated October 15, 2026.
What this calculator estimates
Medicare Advantage Out-of-Pocket Calculator
Inputs and units
Use the units shown for Monthly plan premium excluding Part B ($), Expected annual covered medical charges ($), Average member cost share (%), Expected annual copays ($), Plan in-network out-of-pocket maximum ($). Required fields cannot be blank. Use zero only where that field and the model allow it. Select Calculate after changing a scenario.
Method and assumptions
The covered medical estimate is annual allowed charges times the assumed member percentage plus entered copays, capped at the entered in-network medical maximum. Add twelve monthly plan premiums. A maximum of zero produces zero covered medical cost.
Worked example
A 35 monthly plan premium and a zero covered-medical maximum produce 420 annual plan cost in this simplified scenario.
Limitations
Part B premiums, Part D drug expenses, non-covered services and out-of-network costs are outside this estimate. Avoid entering copays already included in the average percentage. A plan's actual service-specific costs and annual limit control.