When you turn 65, Medicare becomes part of the conversation—whether you’re ready for it or not. And if you’ve ever tried to research your options, you know it doesn’t take long to get overwhelmed by all the choices, opinions, and alphabet soup of terms. Original Medicare, Medigap, Medicare Advantage—what do they all mean, and which one is right for you?
Let’s start with the foundation: Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance). It’s run by the federal government and covers about 80% of your healthcare costs. That might sound like a decent deal, but the key number to pay attention to is the 20% that you’re left responsible for. There’s no out-of-pocket maximum. So, a $100,000 surgery could leave you with a $20,000 bill. Ouch.
To avoid that financial exposure, many retirees opt for a Medicare Supplement plan, also known as Medigap. This private insurance plan helps cover the remaining 20% (minus a small deductible for Part B, currently $257/year). Medigap plans are a favorite for those who want to see any doctor who accepts Medicare, especially if you travel a lot or want to avoid the limitations of provider networks. However, premiums go up over time—often increasing by $8 to $10 every 6-12 months. Over the course of 7-10 years, your $125 premium could double to $250 or more.
Then there’s the increasingly popular option: Medicare Advantage (also called Part C). These plans are run by private insurance companies and include all the benefits of Original Medicare, often with extras like dental, vision, hearing, gym memberships, and prescription drug coverage. Many of them advertise $0 monthly premiums. That doesn’t mean you pay nothing—it just means you don’t have a fixed monthly cost like you do with Medigap. Instead, you’ll have co-pays and deductibles based on the services you use, but you’ll also have a cap on your total out-of-pocket expenses (around $3,900 for in-network care in many areas).
So which one’s better? That depends on you. Do you value flexibility and low out-of-pocket costs, even if premiums increase? Medigap might be your best bet. Do you want predictable spending and don’t mind sticking to a network of providers? Medicare Advantage could save you money and offer more perks.
Here’s the truth: There’s no one-size-fits-all answer. Every person’s health needs, budget, and lifestyle are different. That’s why working with an independent broker is so valuable. I help clients every day weigh these options, compare plans across multiple carriers, and make a choice that’s not just good on paper—but actually works in real life.
The Medicare decision is one of the most important choices you’ll make in retirement. Don’t leave it up to chance or a TV commercial. Talk to someone who can explain your options, answer your questions, and help you make a decision with confidence.
Working with is always free to you, there's no reason to navigate the maze on your own. Register for a free in person seminar or schedule a one on one session to discuss your options.