Medicare Made Easy… Should You Switch Plans?

I did the research so you don’t have to.

Understanding Traditional Medicare vs. Advantage Plans

Traditional Medicare

Traditional Medicare is operated by the government and is a combination of Medicare Parts A (hospitalization) and Parts B (Physicians and testing), and Part D (drug plan). Traditional Medicare covers 80% of your health care costs. To cover the remaining 20%, you must buy a Medigap, or supplemental, policy.

Cost

The cost for traditional Medicare for 2026 is estimated to be $206.50 monthly. The cost for a supplemental plan (G Plans), the most popular supplemental plan costs $100-$200/month.

Traditional Medicare

The Good News

• You cannot be turned down for the best, most comprehensive (and expensive) plan (currently Plan G), even if you already have health issues. 
• Almost all doctors and hospitals accept Traditional Medicare. You have the widest access to health providers.
• Out-of-pocket costs are limited to the annual Park B deductible, estimated at $288 in 2026.

The Bad News

• The premium for a supplemental policy is more than for Advantage Plans.
• You still must buy a separate drug plan (Part D).

Advantage Plan

Advantage plans are operated by private insurance companies that contract with Medicare. 

Cost

You still must pay the cost for traditional Medicare (estimated 2026 premium of $206.50/month. 

Advantage Plans

The Good News

• They often include additional benefits (dental, vision, hearing), that traditional Medicare does not cover.
• They usually include coverage (Part D), which is extra in Traditional Medicare.

The Bad News

• Many doctors and hospitals are dropping out of Advantage Plans because of declining reimbursement and paperwork nightmares.
• They require permission for testing and limited access to physicians and hospitals that are part of the group. Going out of network can mean higher costs or no coverage at all.
• Prior authorization is required for many services, which can delay or prevent needed care.
• Although premiums may be lower, Advantage Plans have higher co-payments, deductibles, and out-of-pocket maximums (in 2025, the out-of-pocket maximum for Medicare Advantage Plans is $9350 for in-network services).
• They may not offer coverage outside of their service area, which can be a problem when you travel. 

Bottom Line

• Open enrollment occurs from Oct. 15^th to Dec. 7^th. This is the only time you can choose or change plans. 
• Check the notice your current plan sent you. How much have premiums and costs risen? Are your doctors and hospitals still in the Plan?

Resources to help you:

• Medicare.gov
• eHealth.com
• Boomerbenefits.com
• For personalized help, make sure you use a licensed individuals – not from an Advantage salesperson who earns a larger commission for selling those plans.