When you turn 65, Medicare asks you to pick a path. Both paths can work well, but they work very differently, and some choices are hard to undo.
- Original Medicare plus Medigap and Medicare Advantage are two different paths
- Medigap helps pay costs Original Medicare leaves behind
- Medicare Advantage replaces Original Medicare with a private plan
- Your first window to choose matters, so look before you enroll
The two paths
Path one: Original Medicare plus Medigap. Original Medicare is run by the government. It has gaps, like deductibles and coinsurance. A Medigap plan, also called Medicare Supplement, is sold by a private company to help pay some of those costs. Most people on this path also add a separate drug plan, called Part D.
Path two: Medicare Advantage. Also called Part C. A private insurance company runs your coverage in place of Original Medicare. Most plans include drug coverage and may add extras such as dental or vision.
Side by side
| Original Medicare + Medigap | Medicare Advantage | |
|---|---|---|
| Who runs it | Government, plus a private supplement | A private insurance company |
| Choosing doctors | Any provider that accepts Medicare | Usually a plan network |
| Monthly cost | Part B premium plus a Medigap premium | Part B premium plus any plan premium |
| Costs when you use care | Often lower and more predictable | Copays and a yearly out-of-pocket limit |
| Drug coverage | Separate Part D plan | Usually included |
| Extras like dental or vision | Not included | Often included |
Plans and prices vary by area and by year. Texas plans are not the same in every county.
Mistakes to avoid
- Not checking your doctors. If you have doctors you want to keep, ask whether they take the plan before you enroll.
- Not checking your drugs. Look up each prescription on the plan's list.
- Missing your Medigap window. In many cases, you have a limited time after you first enroll in Part B when you cannot be turned down or charged more for health conditions. Later, a company may be able to ask health questions.
- Missing your sign-up window. Late enrollment can bring penalties that last.
How taxes fit in
Medicare premiums can rise with income. Both paths can be affected. Planning your income before you turn 65 may help you avoid surprises.
There is no one right answer. The better choice depends on your doctors, your health, your budget and where you live. If you are close to 65, start early and let's talk.
Book a consultationSources and references
This article is general information, not tax or investment advice for your situation. Plans and rules change; talk with a licensed professional before choosing coverage.
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