Choose a Medicare Supplement if keeping any doctor and knowing your costs in advance matter most to you. Choose Medicare Advantage if a low monthly premium and built-in extras matter more and your doctors are in the plan's network. Neither is the wrong answer. They fit different people.
How a Supplement works
You keep Original Medicare and add a Medigap policy from a private insurer. Medicare pays its share, the Supplement pays most or all of the rest. You see any doctor or hospital in the United States that accepts Medicare, with no referrals and no network. You pay a monthly premium that depends on your age, ZIP code and plan letter, and you add a separate Part D drug plan.
What you get: predictability. A serious illness costs you roughly the same as a healthy year.
How Advantage works
A private insurer takes over your Medicare benefits. Most plans have a network, an HMO or a PPO, with copays for each visit and a yearly out-of-pocket maximum that can reach several thousand dollars. Drug coverage is usually included, and so are extras such as dental, vision, hearing, gym memberships and over-the-counter allowances. Premiums are low, often $0 on top of your Part B premium.
What you get: low fixed costs while you are healthy, and a cap on the worst year.
The questions that decide it
Is there a doctor or hospital you will not give up? Check whether they are in the Advantage network. If not, that answers it.
Do you travel or spend part of the year in another state? A Supplement works everywhere. Most Advantage plans cover only emergencies outside their area.
Can your budget absorb a bad year? An Advantage plan's out-of-pocket maximum is real money. A Supplement premium spreads it out.
Do you want dental and vision built in? Advantage plans include them, and often hearing aids as well. With a Supplement you buy that coverage separately.
The switch back is the catch
You can move from a Supplement to Advantage any Annual Enrollment. Moving back is harder. After your first year, a Supplement company can ask health questions and turn you down. So the first choice matters more than people expect. Read the answer on switching back before you choose Advantage.
The home page has a four-question checker that shows which way you lean. Then request a plan check and I compare real plans against your doctors and prescriptions.