How to Choose the Best Medicare Plan: 5 Key Questions for Smart Decision-Making

Choosing the right Medicare plan is a crucial decision that affects both your healthcare coverage and financial security. With multiple options available—Original Medicare (Part B), Medicare Supplement (Medigap), and Medicare Advantage—many people struggle to determine which plan is best for their needs.

To simplify this process, here are five essential questions you should ask before enrolling in a Medicare plan.

1. Do You Have a Tight Monthly Budget?

For many, healthcare costs are a major concern in retirement. Understanding your budget will help you decide which Medicare plan best aligns with your financial situation.

• Medicare Part B: The 2025 Part B premium is $185 per month for single filers earning $106,000 or less and married couples earning $212,000 or less. Higher-income individuals pay additional surcharges.
• Medicare Supplement Plans (Medigap): These plans have additional premiums but provide predictable costs.
  • Plan G: $150/month
  • Plan N: $120/month
  • Drug Plan (Part D): $25/month
  • Total estimated cost for Plan G: $360/month
  • Total estimated cost for Plan N: $330/month
• Medicare Advantage Plans: Many have low or $0 monthly premiums but require co-pays and out-of-pocket costs when services are used.

If predictability and budgeting are a priority, a Medigap plan might be better, whereas lower monthly costs favor Medicare Advantage.

2. How Much Financial Risk Can You Tolerate?

Understanding your comfort level with out-of-pocket medical expenses is essential when choosing a plan.

• Medicare Part B only: Unlimited out-of-pocket expenses, making it risky for those with frequent healthcare needs.
• Medigap Plans: Offer stable, predictable costs, with a Medicare Part B deductible of $257 in 2025.
• Medicare Advantage Plans: Have out-of-pocket maximums, but they vary:
  • HMO plans: $3,000 – $5,000 per year
  • PPO plans: $4,000 – $10,000 per year

If you prefer fixed costs over financial uncertainty, Medigap provides better protection. If you can manage higher out-of-pocket risk to save on premiums, Medicare Advantage may work for you.

3. Do You Want Permanent or Temporary Insurance?

Medicare plans differ in terms of contract duration and portability:

• Medigap (Medicare Supplement):
  ✅ Lifetime contract—your coverage cannot be canceled as long as you pay your premiums.
  ✅ Portable across the U.S., meaning you can receive care anywhere that accepts Medicare.
• Medicare Advantage (Part C):
  ❌ Annual contract—plans change yearly, and benefits are not guaranteed long-term.
  ❌ Service area restrictions—coverage is limited to specific geographic areas, and moving to another state may require enrolling in a new plan.

If you want long-term stability, Medigap is the better choice. If you’re comfortable reassessing your plan annually, Medicare Advantage may work.

4. Do You Want to Choose Your Own Doctors?

Doctor choice is a major factor in Medicare plan selection:

• Medigap (Medicare Supplement):
  ✅ Allows open access to any doctor or specialist who accepts Medicare—no referrals required.
• Medicare Advantage:
  ❌ HMO Plans require you to stay in-network and get referrals for specialists.
  ❌ PPO Plans allow out-of-network care but at higher costs.

If you want the freedom to choose your doctor, Medigap is the better option. If you’re okay with network restrictions in exchange for lower costs, Medicare Advantage works.

5. Who Do You Want Making Your Healthcare Decisions?

Medicare plans differ in pre-authorization requirements:

• Medigap:
  ✅ No pre-authorization needed—as long as Medicare covers the service, you can receive care without additional approvals.
• Medicare Advantage:
  ❌ Requires pre-authorization for costly services (surgeries, specialist visits, MRIs, etc.), potentially causing delays or denials.

If you prefer direct access to healthcare decisions, Medigap is the way to go. If you’re comfortable having an insurance company approve certain treatments, Medicare Advantage could be suitable.

Making the Right Medicare Choice for You

Choosing between Medicare plans depends on your budget, risk tolerance, long-term goals, doctor preferences, and control over healthcare decisions. Here’s a quick summary to guide you:

Final Tip: If you prioritize flexibility, stability, and broad access to doctors, Medigap is the better choice. If you prefer lower monthly costs and can manage network limitations, Medicare Advantage may work.

Do you need help selecting the best Medicare plan for 2025? Share your questions below, and let’s navigate your options together!