What is the best supplement insurance to have with Medicare?

Yes, Medicare supplemental insurance (Medigap) is usually worth it because Original Medicare leaves you responsible for a 20% coinsurance and has no annual out-of-pocket maximum.

Why Supplemental Insurance Is Worth It

• Predictable costs: Plans like Medigap Plan G cover nearly all out-of-pocket expenses outside of your yearly Part B deductible.
• No network limits: You can see any doctor or go to any hospital in the country as long as they accept Medicare.
• No referrals needed: You can visit specialists directly without waiting for primary care pre-approval.
• Protection from big bills: A major medical event or hospital stay will not result in uncapped 20% coinsurance charges.
• No prior authorization: Insurance companies cannot delay or deny treatments that Medicare already approves.

When Supplemental Insurance Might Not Be Worth It

• High monthly premiums: If you are healthy and rarely see a doctor, paying a high monthly premium might cost more than paying out-of-pocket for occasional visits.
• Alternative coverage: If you choose a Medicare Advantage plan instead of Original Medicare, you cannot buy a Medigap policy. Advantage plans often bundle extra perks like dental or vision, though they use strict local networks.
• Extra costs for extras: Medigap policies do not include prescription drugs (Part D), vision, dental, or long-term care, meaning you must buy separate standalone plans for those needs.
• Opinions on Reddit are mixed: some users note that high Medigap premiums price people out, making Medicare Advantage a necessary alternative despite its network restrictions and pre-approval hurdles.

The biggest downsides of Medigap are high monthly premiums, no prescription drug coverage, and a lack of extra perks like routine dental, vision, or hearing care.

Major Drawbacks of Medigap

• High Monthly Costs: You must pay a separate monthly premium to a private insurer on top of your standard Medicare Part B premium. These premiums often increase as you age.
• No Prescription Drugs: Medigap policies do not cover outpatient prescription drugs. You must buy a separate Medicare Part D plan, meaning multiple premiums and cards.
• No Extra Benefits: Medigap does not pay for routine dental, eye exams, hearing aids, or gym memberships.
• Underwriting Restrictions: If you miss your initial 6-month Medigap Open Enrollment Period (which starts when you turn 65 and enroll in Part B), insurers can use medical underwriting. They can charge you more or deny you coverage entirely due to pre-existing health conditions.

Kaiser Permanente and Alignment Healthcare rank highest for star ratings, with 100% of their members in plans rated four stars or higher.

Top-Rated National Companies

• Kaiser Permanente: Achieves top marks with 100% of members in 4+ star plans, though its availability is limited to select states.
• Alignment Healthcare: Also ties at 100% for members in highly rated plans, but operates in a smaller number of states.
• Aetna Medicare: Leads among major national carriers with wide availability, having over 81% of members in plans rated 4 stars or higher.
• UnitedHealthcare: Follows closely, with 78% of its members in 4+ star plans and the largest nationwide provider network.

Ratings vary significantly by location, and specific plan performance depends heavily on your local county and ZIP code. You can check specific plan quality using the Official Medicare Plan Finder.

Yes, you can drop your Medicare Advantage plan and return to Original Medicare, but you can usually only make this change during specific times of the year.

When You Can Switch

• Annual Enrollment Period (October 15 – December 7): You can switch from a Medicare Advantage plan back to Original Medicare. The change takes effect on January 1 of the next year.
• Medicare Advantage Open Enrollment Period (January 1 – March 31): If you already have a Medicare Advantage plan, you can drop it and return to Original Medicare during these months. The change takes effect the first of the month after the request is received.
• Special Enrollment Periods: You can change plans outside these windows if you experience a qualifying life event, such as moving out of your plan's service area.

Important Things to Consider

• Prescription Drug Coverage: Original Medicare does not include prescription drug coverage. If you leave Medicare Advantage, you should sign up for a stand-alone Medicare Part D prescription drug plan to avoid late enrollment penalties.
• Medigap (Supplement Insurance): Original Medicare leaves out-of-pocket costs like co-pays and deductibles. You may want a Medigap policy to help pay these costs. However, outside your initial enrollment window or specific trial periods, insurance companies in most states can use medical underwriting to deny you a Medigap policy or charge higher rates based on your health.

How to Make the Switch

• Call 1-800-MEDICARE (1-800-633-4227) for live assistance.
• Contact your current Medicare Advantage plan to request cancellation.

The biggest mistake seniors make when enrolling in Medicare is missing key enrollment deadlines, which can lead to permanent, lifelong late-enrollment penalties and gaps in medical coverage.

Top Medicare Enrollment Mistakes

• Missing the Initial Enrollment Period (IEP): Your window to sign up is a 7-month period that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Missing this window without qualifying for a special enrollment period leads to delays and penalties.
• Failing to Understand Work Rules: Many seniors either sign up for Part B when they don't need to (because they are still working and covered by an employer with 20 or more employees) or fail to realize they must sign up when they retire, missing their 8-month special window.
• Ignoring Prescription Drug Coverage (Part D): Failing to sign up for Part D when first eligible—even if you take no medications—can trigger a permanent 1% penalty added to your monthly premium for every month you delayed.
• Confusing Advantage and Supplement Plans: Assuming a low-premium Medicare Advantage plan always means lower overall out-of-pocket costs without checking network restrictions, copays, and prior authorization rules. You can read more details on avoiding these errors via the AARP Medicare Guide.