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Original Medicare With No Supplement: Real Costs (2026)

Going without a Medigap plan or Advantage plan means facing Medicare's 20% coinsurance with no cap. Here's what that can really cost in a bad year.

By Jordan Jenkins, Licensed Insurance Advisor, Wyoming & UtahJuly 23, 20265 min read

The short answer

Some people consider keeping just Original Medicare with no supplement to save on premiums. It's legal, but it exposes you to real risk: Original Medicare pays about 80% of covered Part B services, leaving you the other 20% with no annual cap, plus hospital deductibles. In a healthy year that might be manageable; in a serious year, it can be financially devastating.

Going bare saves a premium but trades it for unlimited downside — the opposite of what insurance is supposed to do.

What a bad year can cost

Picture major surgery, a cancer diagnosis, or a long hospital stay. Under Original Medicare alone, you'd owe the Part A hospital deductible (per benefit period), 20% of a potentially large Part B bill for treatments and doctor services, and more — with nothing stopping the total from climbing. There's no out-of-pocket maximum to catch you, as our guide to whether Medicare has an out-of-pocket max explains.

This is exactly the scenario a Medigap plan is built for: it turns that unpredictable 20% into a predictable premium.

How to weigh it

The premium savings from going without a supplement are real, but so is the risk. For most people, the peace of mind and cost predictability of a Medigap plan (or the capped exposure of a Medicare Advantage plan) is worth it. Going bare only makes sense for those with substantial assets who can truly self-insure a catastrophic year — and even then it's a gamble.

If cost is the concern, there are lower-premium ways to get protection, like a high-deductible Medigap plan. Our Medicare Supplement overview covers the options.

Frequently Asked Questions

Can I have Original Medicare without a supplement?

Yes, it's allowed. But you'd face the 20% coinsurance and deductibles with no annual out-of-pocket cap, which is risky in a serious health year.

What could a bad year cost without a supplement?

Potentially a lot — the hospital deductible, 20% of large Part B bills for surgery or cancer treatment, and more, with no cap to stop the total from climbing.

Is going without a supplement ever a good idea?

Only for people with substantial assets who can truly self-insure a catastrophic year, and even then it's a gamble. Most people are better protected with a Medigap or Advantage plan.

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