Which plan should you enroll in?

Traditional Medicare. Medigap. Medicare Advantage. Medicare Parts A, B, C, D, G, etc. Open Enrollment kicks off every year on Oct. 15 and it can be more than a little confusing, especially if it’s your first time navigating the process. Deciding on a Medicare plan is a big decision, and one that can impact you and your family for years to come.

Individual circumstances vary, so we can’t make a blanket recommendation on which plan is best for YOU. But we can break down the broad differences between Traditional Medicare and Medicare Advantage so you can make an informed decision. Dr. Ed Weisbart of Physicians for a National Health Program did just that in a fall 2024 webinar hosted by the Consumers Council of Missouri.

Understanding your Open Enrollment decisions

For most people on Medicare, cost is an an important consideration. Advantage plans tend to offer lower monthly premiums whereas Traditional Medicare plans with a Medigap supplemental policy virtually eliminate out-of-pocket costs. Traditional Medicare requires a separate prescription drug plan while Advantage plans require prior authorization for many procedures and often deny medically necessary care.

State Health Insurance Assistance Program

Insurance brokers also offer guidance on Medicare enrollment, but buyer beware! While there are many honest brokers out there, the federal government tips the scales by allowing insurance corporations to pay substantially higher commissions for Advantage plans than for Medigap supplemental plans ($611 vs. $352). Brokers have a financial incentive to steer people towards privatized plans.

Thankfully, the State Health Insurance Assistance Program—which is federally-funded, state-run, and powered by volunteer counselors—offers unbiased advice to people enrolling in Medicare. Their counselors have no financial interest in which plan you choose, and are especially helpful when it comes to selecting a Part D prescription drug plan or navigating Medigap.

Looking for more resources? Check out a handy checklist for people enrolling in Medicare for the first time from Just Care USA (HERE) and a comprehensive guide to appealing denials and advocating for yourself or a loved one from the Center for Medicare Advocacy (HERE).

Ready to take action? Sign our petition demanding Congress and President Biden protect Medicare beneficiaries by cracking down on insurance company abuses, and by significantly improving the traditional, public Medicare program. Questions? Email mandy@pnhp.org.