“It’s Free.” The Two Words That Cost Medicare Beneficiaries the Most

We hear it constantly.

“I picked Medicare Advantage because it was free.”

We understand why. When you are staring at a $202.90 Part B premium every month and someone hands you a plan with a zero dollar additional premium, the math feels obvious. Keep the money.

But here is what that zero does not tell you.

Medicare Advantage plans make their money on the back end. Low or no premium gets you in the door. Then come the copays, the prior authorizations, the provider networks, and the out-of-pocket maximums that can reach $8,000 to $10,000 or more in a single year. For someone with a serious diagnosis, a surgery, or a rough stretch of health, that zero dollar premium can turn into thousands of dollars in costs very quickly.

There can also be the network problem. Medicare Advantage plans restrict which doctors and hospitals you can use. Original Medicare with a Medigap supplement works with virtually any provider in the country who accepts Medicare. For someone who travels, has a specialist they love, or simply does not want to ask permission before seeing a doctor, that freedom has real value.

None of this means Medicare Advantage is wrong for everyone. For some people in some situations it genuinely makes sense. But the decision should never be made because the premium is zero. That is not a Medicare strategy. That is a marketing win for the insurance company.

The right question is not what does this cost me today. It is what does this cost me when I actually need it.

That is the question we help people answer every day. If you are choosing between Medicare Advantage and a supplement and want a straight conversation about both sides, call us.