If you're turning 65 this year, you're about to face one of the most expensive decisions of your retirement — and most people make it in under an hour.
The fork in the road: Medicare Advantage or a Medigap supplement.
The price tags look wildly different, but the cheaper option up front isn't always cheaper in the end.
Original Medicare covers hospital and doctor visits but leaves you on the hook for 20% of most outpatient costs, with no annual cap.
A Medicare Supplement plan — Medigap — picks up most of that leftover.
You pay a monthly premium, and in exchange, your out-of-pocket exposure shrinks to near zero.
These are private plans that replace Original Medicare, often bundling in dental, vision, and hearing.
What they don't advertise as loudly: deductibles, copays, and an annual out-of-pocket maximum that can run north of $8,000 in-network.
A Medigap Plan G for a 65-year-old might run $120 to $180 a month depending on your state and gender.
But one bad year — a surgery, a cancer diagnosis, a few days in the hospital — can wipe out a decade of those premium savings.
There's a catch that traps people permanently.
When you first enroll in Medicare, you get a six-month window where Medigap insurers must sell you a policy regardless of your health.
Miss it, and you can be denied or charged more for pre-existing conditions.
Switch to Medicare Advantage and later want back into Medigap?
In most states, you may not be able to get in at all.
Medicare Advantage isn't a scam — for healthy people who rarely see doctors, it can genuinely save money.
The plans also cap costs, which Original Medicare alone does not.
Advantage plans often require referrals and in-network providers, which can complicate life if you travel or split time between states.
One more thing people miss: prior authorization.
Advantage plans can require approval before covering certain procedures, and denials are common enough that federal regulators have been scrutinizing the practice.
Look at your health, your medications, and your tolerance for surprise bills.
If you can afford the premium and want predictability, Medigap is the safer bet.
If cash flow is tight and you're healthy, Advantage can work — as long as you go in with open eyes.
Your State Health Insurance Assistance Program offers free, unbiased counseling, and the annual enrollment window is your chance to switch.
Pick with your wallet and your medical history in mind, not the flashiest commercial.
The bottom line: the cheapest premium is rarely the cheapest plan.
Final Thoughts
Treat this like a mortgage decision, not a magazine subscription — because once you've locked in the wrong one, getting out can be the hardest part.