Best Medicare Insurance Plan

Picking the best Medicare insurance plan option could be the most important decision you make when turning 65. It can be unbelievably confusing. Let’s face it, there’s a lot to gain for the people selling you plans. And, potentially, a lot to lose for you if you pick the wrong coverage.

The American Association for Medicare Supplement Insurance does NOT sell insurance. And, while Medicare Supplement is in our name, we know it is NOT the best choice for all. But hundreds of millions of dollars are spent by companies (especially Medicare Advantage providers). And, that may not be your best option.

So, on this page, we attempt to point out the different choices and the pros and cons. Hopefully this information gives you added knowledge. Because only with knowledge can you make better decisions.

Author: Jesse Slome, Director, American Association for Medicare Supplement Insurance
Posted: July 15, 2024  Reviewed by AAMSI

Turning 65: What Are Your Medicare Options

When you turn 65, you have several Medicare options available to you. Here are the main choices you can consider:

1. Original Medicare (Part A and Part B):
   • Part A (Hospital Insurance): Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
   • Part B (Medical Insurance): Covers certain doctor’s services, outpatient care, medical supplies, and preventive services.
2. Medicare Advantage (Part C):
   • Includes all benefits and services covered under Part A and Part B.
   • Often includes prescription drug coverage (Part D) as well as extra benefits like vision, dental, hearing, and wellness programs.
   • Offered by private insurance companies approved by Medicare.
3. Medigap (also known as Medicare Supplement Insurance):
   • Helps pay for costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles.
   • Sold by private insurance companies.
4. Prescription Drug Coverage (Part D):
   • Helps cover the cost of prescription drugs.
   • Can be added to Original Medicare or included in a Medicare Advantage plan.
5. Other Coverage Options:
   • Some individuals may have other health coverage options like employer-sponsored plans, retiree coverage, Medicaid, or coverage from the Health Insurance Marketplace.

Best Medicare Insurance Plan – Finding An Independent Consultant

It pays to speak with a local Medicare agent.

Medicare is national. But your choices are based on where you live.

It pays to include at least 1 local Medicare insurance agent as part of your plan research.

Access the Association’s online directory. It’s 100% private. Enter no personal information other than your Zip Code.

Here are good questions to ask. They’ll help you find the best Medicare insurance plan and agent.

1. How long have you been selling Medicare plan options.
2. Do you sell both Medicare Advantage and Medigap?
3. How many different Medicare insurance companies are you appointed with?
4. Where are you physically located?

Click to access the free online directory listing local Medicare insurance agents

How Many People Have Medicare – Medicare Advantage – Medigap Plans?

According to the American Association for Medicare Supplement Insurance there are 65,748,297 people enrolled in Medicare (2024).

Roughly 33.4 million people were enrolled in a Medicare Advantage plan at the start of 2024.

The American Association for Medicare Supplement Insurance reports that 14 million have Medigap or Medicare Supplement plans (2024).

The remainder have Original Medicare coverage (just Parts A & B).

AAMSI also reports that 11 million people are covered by Medicare Part D stand-alone prescription plans in 2024.

Comparison of Original Medicare and Medicare Advantage

Today the first thing you want to think about are the pros and cons of Original Medicare versus Medicare Advantage.

A Medicare Advantage plan, also called a Part C or MA plan, may sound enticing. They combine Medicare Part A and B. Usually today they include Medicare Part D (prescription drug coverage) into one plan. Some offer extra coverage for vision, hearing, and dental.

MA plans are offered by private companies (either for-profit or non profit) that are approved by Medicare. The private insurers receive a fixed amount each month for Medicare Advantage plan care. As a result, these companies can charge out-of-pocket costs. And they are able to establish their own rules for service such as the need for referrals or provider networks for both non-urgent care and emergency services.

Things To Consider When Choosing A Medicare Advantage Plan

One of the primary reasons why some individuals are opposed to Medicare Advantage plans is due to limited provider networks.

Many Medicare Advantage plans have a restricted network of doctors and healthcare providers that participants must use in order to receive coverage. This limitation can be particularly challenging for individuals who have longstanding relationships with specific healthcare providers or who live in rural areas where access to a broader network may be limited.

Another significant concern is the denial of coverage for necessary care.

Some Medicare Advantage plans have been criticized for routinely denying coverage for certain medical services or procedures, leading to unexpected out-of-pocket costs for participants. This denial of coverage can result in financial burdens for individuals, especially when they require essential treatments that are not approved by their plan.

Moreover, the threat to rural hospitals posed by Medicare Advantage plans is a major issue.

In rural areas, where healthcare options may already be limited, denials of coverage by these plans can further strain struggling hospitals. The refusal to reimburse for services provided by rural hospitals can lead to increased financial pressure on these facilities, potentially forcing some to close down. This closure can leave residents without access to vital healthcare services, creating significant challenges for rural communities.

Additionally, concerns have been raised about the cost implications associated with Medicare Advantage plans.

Despite being marketed as cost-effective alternatives to traditional Medicare, some reports indicate that Medicare pays these plans more than it would under fee-for-service Medicare. This discrepancy raises questions about the actual cost savings achieved through Medicare Advantage plans and whether they truly provide better value for both participants and the government.

Doctor & Hospital Choice

In Original Medicare, you have the freedom to choose any doctors or hospitals that accept Medicare without needing referrals or worrying about network restrictions.

On the other hand, Medicare Advantage plans function like private insurance with HMOs and PPOs, which may have more restrictive provider networks and require referrals for specialists.

Coverage

Both Original Medicare and Medicare Advantage cover preexisting conditions and provide prescription drug coverage via Part D. However, Original Medicare does not typically cover routine dental, vision, or hearing care without additional supplemental coverage (either through a Medigap policy or a standalone dental/vision plan).

Many Medicare Advantage plans offer additional benefits such as dental, vision, hearing care, fitness programs, gym memberships, transportation to doctor visits, over-the-counter drugs, and even some home care services. These extra benefits vary depending on the plan chosen.

Foreign Travel

Original Medicare generally does not cover healthcare services outside the United States except in specific circumstances such as emergency situations or when you are near a U.S. border and a foreign hospital is closer than the nearest U.S. facility.

Some Medigap policies (specifically Plans C, D, F, G, M, and N) offer limited foreign travel emergency coverage with a lifetime limit of $50,000 after a deductible ($250 in 2024 for emergency care).

In contrast, some Medicare Advantage plans may offer limited foreign travel coverage depending on the plan’s terms and conditions; however this varies widely among different plans. Make sure to check your specific plan’s details for information regarding foreign travel coverage if you anticipate traveling outside the United States frequently during retirement.

Medicare Insurance Information Statistics Resources

Access relevant Medicare insurance statistics and information using these links.

2024 Medicare Supplement Price Index – PLAN G. See the lowest and highest premium rates for top-10 U.S. markets.

PLAN N Price Index rates. Lowest and highest rates for top-10 U.S. cities.

Medicare Supplement insurance statistics – what plans people turning age 65 choose.

Find best long-term care insurance costs – free insurance quotes.