If you're turning 65 this year, you're about to face a decision that can swing your health care costs by $5,000 or more annually — and the marketing mailers flooding your mailbox aren't exactly neutral.
The two main paths are Medicare Advantage (Part C) and Medicare Supplement plans, commonly called Medigap.
Medicare Advantage bundles hospital, medical, and often drug coverage into one plan run by a private insurer.
Premiums can be as low as $0 beyond your Part B payment — which is exactly why those flashy ads push it.
But the trade-off hides in deductibles, copays, and networks.
You pay a monthly premium, typically $100 to $200 depending on your state and plan letter, and the policy covers most or all of the gaps Original Medicare leaves behind.
Any doctor in the country who accepts Medicare.
The catch that trips up millions: you get a one-time Medigap open enrollment window that starts when you're 65 and enrolled in Part B.
Miss it, and insurers in most states can charge you more — or reject you outright — based on your health history.
That window matters more than most people realize.
Switch from Advantage to Medigap three years later after a cancer diagnosis, and you may find yourself locked out in 46 states.
Medicare Advantage enrollees do get extra perks — dental, vision, gym memberships, sometimes grocery allowances.
But a 2023 KFF analysis found Advantage plans denied roughly 3.4 million prior authorization requests in a single year, about 6% of them.
And a federal study found some plans systematically denied care that should have been covered.
The average out-of-pocket maximum for Advantage plans sits near $5,000 for in-network care, and higher for out-of-network.
A rough year with a hospital stay can blow past what you'd pay in a full year of Medigap premiums.
If you're healthy, want low upfront costs, and don't mind staying in-network, Advantage can work.
If you travel, see specialists, or want predictable bills, Medigap usually pays off — especially over 10 or 20 years.
One more wrinkle: starting in 2025, the Inflation Reduction Act capped annual Part D drug out-of-pocket costs at $2,000, which softens the math for both paths.
That's real relief for anyone on expensive prescriptions.
Before you decide, check whether your doctors accept the specific Advantage plan — not just "Medicare." Call your hospital.
And if you're leaning Medigap, don't delay past your initial window, because that door closes fast.
Our take: the $0 premium pitch is a marketing hook, not a financial plan.
Final Thoughts
Run your own numbers against last year's actual medical bills, and treat that one-time Medigap enrollment window like the deadline it is.