Ron Bliss: Medicare Supplement or Advantage: Which way to go if you are turning 65

If you are turning 65, one thing is for certain — you are being bombarded in the mail or by phone with information about Medicare. If you are like most, your head is spinning.

This blog is designed to help you decide what is best for you.

You can choose to go with just Part A and Part B, plus a Part D plan and not pay for either a Medicare Supplement or a Medicare Advantage plan. But by doing so, you expose yourself to heavy expense. Without a supplement or Medicare Advantage, you not only have to pay the Part A deductible of $1,280 the first day you are hospitalized, but co-pays for each day past 60 days you are hospitalized.

You also have to pay the Part B deductible of $166, plus 20 percent of all charges for Part B services. As I like to tell my customers, 20 percent of $100,000 is $20,000.

By getting either a Medicare Supplement or a Medicare Advantage plan, you give yourself a safety net. My mother had back surgery a few years back. The hospital bill, alone, was $86,000. Her cost was $0. Her supplement paid it all.

So not going with anything other than Parts A, B and D is not a wise decision.

So which way should you go?

In most cases, if you can afford it, the Medicare Supplement route is the best way to go.

The reason? It helps you stay within your budget better and usually costs less than you were paying for Major Medical when under 65.

When you have an F or G Medicare Supplement, the most you pay out of pocket is $166. For the F plan, you pay the premium and that is it, and for the G plan, you pay the $166 deductible for Part B and everything else is covered.

For one of these plans, you can expect to pay between $115 and $220 per month, depending on which company you go with.

Everyone is going to pay the Part B premium ($121.80 for most), no matter whether you get a Medicare Supplement, a Medicare Advantage plan or just stay on standard Medicare.

Those getting a Medicare Supplement have to also factor in cost of a Part D drug plan. Premiums for the Part D plan range from $18.40 to well over $100 per month, depending on your needs. You will also have co-pays on your drugs. Even if you don’t need any prescription drugs, it is best to go ahead and get it to avoid a mandatory penalty for not having a plan that could get very expensive when the time comes where you need a Part D plan.

So, why go with a Medicare Supplement when a Medicare Advantage plan costs less in premium?

Co-pays.

With Medicare Advantage, you can expect to pay a lot of co-pays and you could have an out-of-pocket limit of well over $3000, if you get sick or injured.

In short, Medicare Advantage works for those who don’t need to see the doctor much. They can get expensive, however, if you happen to go into the hospital.

Medicare Advantage plans generally charge $250 co-pays or more for the first six days.

You can buy a Medicare Supplement that will pay all of you hospital expenses and have it cost less in an entire year than you would pay for a just a few days in the hospital.

Before deciding which way to go, call Affordable Healthcare Pros first. We can advise you, free of charge, and either give you a choice of 10 different Medicare Supplements or can refer you to one of the Medicare Advantage plans we work with, if you decide that is the best thing for you.

We can also help you cancel your existing Under-65 insurance and help you get set up for a Part D drug plan.

Call me at 775-224-7169, call our office at 775-883-3414 or come by our office at 2307 N. Carson Street in Carson City to set up an appointment. We will look forward to helping you make this difficult decision.

Ron Bliss is a former long-time sports writer who has been doing health and life insurance since 2009. He is certified on both Covered California and the Nevada Health Link and can sell products on and off both exchanges. Affordable Healthcare Pros also offers a variety of dental plans to include dental-vision-hearing plans in both states, as well as a wide variety of Medicare supplements, can refer you to a Medicare Advantage plan or help you with other health supplemental products to include critical illness, disability, plans to cover in-home or nursing home costs, accidents and hospital indemnity policies. He can also give you the choice of a number of Life Insurance carriers.