Every fall, your mailbox fills up with glossy promises.
One envelope says you can get dental, vision, and a gym membership for a $0 monthly premium.
Another warns that if you don't buy a Medigap supplement now, you'll be locked out forever.
Both can't be telling the whole story, and neither one is free.
Here's the part the ads gloss over: with Medicare Advantage, the government pays a private insurer a set amount per member, and that insurer keeps whatever it doesn't spend on your care.
That's not automatically bad, but it explains why networks stay narrow.
You generally have to stay in-network, and referrals for specialists are common.
The $0 premium is real, but the trade-off is control.
Original Medicare plus a Medigap supplement works differently.
You pay a monthly premium to the supplement carrier, often $100 to $200 or more depending on your state and age, and in exchange it covers most of what Medicare doesn't — deductibles, coinsurance, the 20% that can add up fast.
You can see any provider who accepts Medicare, no network required.
Medigap insurers in most states can deny you or charge more based on health history once you're past your one-time Medigap Open Enrollment window, which starts when you're 65 and enrolled in Part B.
Miss it, and a past diagnosis can follow you for years.
Medicare Advantage has its own annual enrollment windows and you can often switch plans, but switching back to a supplement later is where people get stuck.
Insurance brokers earn commissions on both, but Advantage plans often pay higher and recurring commissions, which is one reason the marketing skews that direction.
The federal government likes Advantage because it caps its per-person spending.
You're the one left comparing networks, drug formularies, and out-of-pocket maximums that can hit $8,000 or more on some Advantage plans.
Neither option is universally better, and anyone who tells you otherwise is selling something.
If you can afford the supplement premium and want to keep your doctors, run the math on Medigap.
If premiums are tight and you're healthy, Advantage can work — just read the formulary and the network list before you sign.
Check plan ratings, call your doctors to confirm they're in-network, and price your prescriptions both ways.
The answer is different for a 66-year-old in Florida than a 72-year-old in Minnesota.
It's the pressure to decide in a single enrollment window based on a mailer.
Take the extra week, talk to a fee-only advisor if you can find one, and treat the commissions behind the pitch as exactly what they are.
Our take: the $0 premium is a marketing number, not a measure of value.
Run your own drug and doctor math before you trust anyone who profits either way.
Final Thoughts
The best plan is the one that still fits when you actually get sick.