Simplify Your Medicare Supplement Decision Making by Focusing on Just 5 Things

Your MEDICAL CONDITIONS will determine the CARE that you need.
The CARE required will determine both your need for CONTROL and the COSTS you incur.
CONTROL refers to the following:
- The ability to see any provider (doctor, hospital, urgent care, etc.) of your choice without having to work through provider network.
- The ability to undergo any test or treatment your doctor recommends as long as it is a covered Medicare benefit. This means that you would NOT have to worry about getting pre-authorizations or pre-approvals for your treatment or testing.
- In other words, having CONTROL means that both you and your doctors have freedom of choice about your care.
- Original Medicare (or Medigap) plans offer the greatest extent of control.
COSTS are primarily incurred in 2 ways:
- Up Front Costs: These are based on the premiums you may pay. With these plans your medical costs in any given year will never be greater than your annualized premium + a small deductible. (The Medicare Part B 2026 deductible will be $288)
  - The example above is for a Medigap Plan G which offers the most comprehensive coverage. (Plan G also has the highest premium of the Medigap Plans). There are other Medigap plans with lower premiums although these would be associated with varying degrees of co-payments and co-insurance. However, it is also important to note that ALL Medigap Plans will still allow you and your doctor the freedom to have CONTROL over your care (as outlined above)
  - Pay as You Go: Most of these plans fall into the category of Medicare Advantage (also called Medicare Part C) plans.
    - These plans typically have either little or no premium, meaning you will often NOT pay anything unless some type of treatment is required.
    - Co-payments and/or co-insurance is paid when care is received and the extent of such co-pays or co-insurance is dependent on the type of treatment or testing required.
    - Medicare Advantage Plans also usually have a higher yearly maximum out of pocket limit (called MOOP) as compared to Medigap Plans.
COLLATERALS are the 4th factor to consider, meaning things that are included with the plan at no extra charge such as:
- Dental Benefits
- Fitness Benefits
- Grocery and Over-the-Counter Spending allowances
- Vision and Hearing Benefits.
- Some plans even offer a monetary “giveback” to help offset Medicare Part B premiums.
CASH FLOW: Here you ask yourself is it better to spend your money on premiums up front to have freedom and control of your care or is it more important to have minimal to no premiums yet still have the collateral extra benefits knowing that you give up some degree of freedom and control of your care.