4 Questions to Help You Pick The Right Medicare Plan

Choosing between a Medicare Supplement and a Medicare Advantage Plan can be overwhelming. 

It’s confusing, and it can feel like it’s easy to make the wrong choice. 

And everyone you ask for help has a different opinion about which one is better. It’s also hard to trust those strong opinions, knowing that some agents have an agenda and care only about their commissions. 

So, we want to make things much easier for you. 

If you focus on four key questions, you’ll get a clearer picture of which plan could be the best fit for you. 

4 Key Questions to Choose the Right Medicare Plan for You

Question 1: Do You Want Lower Monthly Costs (Premiums) or Lower Risk When You Get Care (Out-of-Pocket Costs)?

• Premiums are the monthly cost of the plan you choose. You have to pay this amount to keep your plan, even if you never use it. 

• Out-of-Pocket Cost is how much you will spend if you have to use your plan by seeing a doctor or going to the hospital, etc. 

Generally, you’ll have to choose between plans with high premiums but low out-of-pocket risk, or plans with low premiums but high out-of-pocket risk. 

There are exceptions, but this is usually how health insurance works. 

For Medicare, people who prefer low out-of-pocket risk generally choose a Medicare Supplement Plan, while those who prefer low premiums usually pick a Medicare Advantage Plan. 

Medicare Supplement Plans like Plan G or Plan N usually have significantly higher monthly costs than Medicare Advantage Plans. A Medicare Supplement Plan G can cost anywhere from $100-300 a month, depending on your age and which part of the country you live. 

Plus the premiums of Medicare Supplement Plans generally increase as you age. This depends on the insurance company, but we’ve seen several cases where a Medicare Supplement that costs someone $150/month at 65 went up to around $300/month at age 73. 

To find the exact cost of Medicare Supplement Plans in your area, contact a licensed insurance agent for help. If you don’t have an agent in mind, you can call us at +1-877-360-6565 (TTY 711). We’re happy to help.

The trade-off is that Medicare Supplement Plans cover most of your costs when you need to use the plan. 

If you enroll in a Medicare Supplement Plan G, the only out-of-pocket cost you have to pay every year is the Medicare Part B deductible, which is set to $257 in 2025. 

Medicare Advantage Plans have significantly lower premiums than Medicare Supplement Plans. In fact, you can find Medicare Advantage Plans that offer a $0 premium — meaning you don’t have to pay anything to sign up and keep the plan. 

However, Medicare Advantage Plans generally have higher out-of-pocket costs compared to Medicare Supplement. 

When you go to the hospital or visit your doctor, you usually have to pay a deductible before your plan starts covering you. Once your deductible is paid, you may also have to pay copays or coinsurance every time you use your plan. 

Medicare Advantage Plans also have maximum out-of-pocket (MOOP) limits. Once your out-of-pocket spending reaches your plan’s MOOP, you no longer have to pay copays or coinsurance for the rest of the year. 

Medicare Advantage Plans are free to set their own MOOP. We usually see plans with a MOOP of $3,000 – $5,000. However, in some areas, there are plans with very low limits such as $750, while in other areas, MOOPs can reach $8,000 – $10,000. 

Contact a licensed insurance agent to learn the cost of Medicare Advantage Plans in your area! 

So, if you like peace of mind and don’t want surprise bills, especially if you know you’ll be using your plan more, Medicare Supplement may be the answer. 

But if you want to keep costs each month lower, and don’t expect frequent medical needs, Medicare Advantage might be for you. 

Question 2: Do You Have Preferred Doctors?

If you have a favorite doctor, this will affect which plan is the best fit for you. 

Medicare Supplement Plans cover any doctor or hospital that takes Medicare — they don’t have networks. 

Most doctors (roughly 98%) in the United States take Medicare, which means you can go to almost any doctor, and your plan should cover you. 

Medicare Advantage Plans typically have networks of local doctors and hospitals they work with to provide low-cost healthcare. 

If you want services outside of your plan’s network, you may not be covered (most HMO plans), or you may have to pay higher copays (most PPO plans) unless it’s an emergency. 

That’s why if you want to continue seeing your preferred doctor, it’s critical to check which plans they take. 

Question 3: How Will You Cover Your Prescription Drugs?

No matter which path you choose, Medicare Supplement or Medicare Advantage, think about how you want to cover prescription medications — because Original Medicare does not cover most prescription drugs at pharmacies. 

To get coverage for that, you may need a Medicare Part D plan for prescription drug coverage. 

There are generally two ways to do this: standalone Medicare Part D prescription drug plans (PDP) — which are often paired with Medicare Supplement Plans — or Medicare Advantage prescription drug plans (MAPD). 

Medicare Supplement Plans don’t cover most prescription drugs sold at pharmacies, which is why many people also enroll in a Medicare Part D prescription drug plan (PDP) for drug coverage. The average cost of a PDP is around $46.5/month in 2025.

Medicare Advantage Prescription Drug Plans (MAPD) are Medicare Advantage Plans that have built-in prescription drug coverage. Most Medicare Advantage Plans have these, so you usually don’t have to enroll in a separate drug plan with Medicare Advantage.

Before enrolling in a drug plan, it’s critical to check which drugs it covers first, since plans are free to choose which drugs they cover and at what cost. 

All Medicare Part D plans, whether PDP or MAPD, must cover: 

• At least two drugs per drug category (drug categories consist of drugs that treat the same symptoms or have the same effects.)
• All drugs in these six protected categories:
  • Anticancer drugs
  • Anticonvulsive treatments
  • Antidepressants
  • Antipsychotic medications
  • HIV/AIDS treatments
  • Immunosuppressant drugs

Besides that, Medicare Part D plans are free to choose which drugs they cover, and at what price.  

So check before you enroll. You can find a full list of drugs covered by a plan by checking its drug formulary. 

Question 4: What Extra Benefits Are Important to You?

What else do you need covered? Think routine dental care, routine eye exams, hearing aids, and several other services like gym memberships or even grocery benefits. 

Medicare Supplement Plans rarely have other benefits. You can think of these plans as “healthcare coverage only,” with very few extras. 

Medicare Advantage Plans often include benefits for dental, vision, and hearing care. Many plans also have perks such as gym memberships, Flex Cards, grocery benefits, transportation benefits, and more. 

Extra benefits should not be the main deciding factor while choosing a Medicare Plan. However, if you’ve studied your options and still can’t decide, these perks might sway your decision.. 

Finding The Right Plan Fit For You

Keep these four questions in mind to cut through the confusion of finding the right plan for you. 

• Do You Prefer Low Premiums or Low Out-of-Pocket Risk? Because people who prefer peace of mind and low out-of-pocket risk lean towards Medicare Supplement, while people who want low premiums tend to go for Medicare Advantage.

• Do You Have Preferred Doctors? If so, be sure to look for a plan that covers your favorite doctors. Medicare Supplement covers any doctor that takes Medicare, while Medicare Advantage Plans have networks of doctors and hospitals that they work with. 

• How Will You Cover Your Prescription Drugs? Medicare Supplement Plans do not cover prescription drugs, so you may need to enroll in a standalone Medicare Part D (PDP) plan for coverage. Meanwhile, many Medicare Advantage Plans have built-in prescription drug coverage (MAPD) with the plan. Keep in mind that plans are free to choose which drugs they cover and at what cost, so be sure to check the plan’s drug formulary before enrolling.   

• Are Extra Benefits Important to You? Medicare Supplement Plans generally only cover what Original Medicare covers, so there are little to no extra benefits. On the other hand, most Medicare Advantage Plans have plenty of perks like benefits for dental, vision, and hearing, gym memberships, Flex Cards, and more. 

With those four questions, you should have a good idea of what type of plan will work best for you. 

The next step is to find the exact details of the plans available in your area. If you need help, call or text our team of licensed insurance agents at +1-877-360-6565 (TTY 711), or click the button below.