Do I still pay Medicare premiums with an Advantage plan?

Yes, you must continue paying your Medicare Part B premium even with a Medicare Advantage (Part C) plan, and some plans also have their own monthly premium, though $0 premium options exist; these plans cover Part A and B benefits but still involve costs like deductibles, copays, and coinsurance, with some plans even helping pay your Part B premium.

Do you still pay for Medicare if you have an Advantage plan?

To join a Medicare Advantage plan, you must also be enrolled in Medicare Parts A and B. Part B has a separate premium that you must pay even if you enroll in a Medicare Advantage plan. The standard Part B premium in 2026 is $202.90 per month.

Does everyone have to pay $170 a month for Medicare?

If you don't get premium-free Part A, you pay up to $565 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($202.90 in 2026).

What is the biggest disadvantage of the Medicare Advantage plan?

The biggest disadvantage of Medicare Advantage (MA) plans is often the limited provider networks and restricted access to care, requiring prior authorizations, referrals, and potentially forcing you to switch doctors or travel far for specialists, creating barriers to timely treatment, especially for complex health issues, with potential for denials and mid-year changes. While MA offers extras like dental/vision, these networks can significantly limit choice and create hurdles for consistent, high-quality care compared to Original Medicare. 

Why is there no premium for Medicare Advantage plans?

Private insurance companies are able to offer zero-premium Medicare Advantage plans, in part, because: To help manage costs, Medicare Advantage plans usually enter into contracts with a network of doctors and hospitals.

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Is it better to have plain Medicare or Medicare Advantage?

Neither Original Medicare nor Medicare Advantage (MA) is universally "better"; the best choice depends on your healthcare needs, budget, and preference for provider choice, with Original Medicare offering nationwide provider freedom but requiring separate drug/supplement plans, while MA provides all-in-one coverage with networks and extra benefits like dental/vision but often requires referrals and has regional limits. 

Why are seniors losing Medicare Advantage plans?

Citing decreased federal payments and rising health care costs, the private health insurers Martin's Point, UnitedHealth and Anthem are pulling their Medicare Advantage plans from New Hampshire in 2026. In Cheshire County, only two insurers will continue offering Medicare Advantage plans.

Can I drop my medicare advantage plan and go back to original Medicare?

Yes, you can drop your Medicare Advantage (MA) plan and return to Original Medicare, typically during the Annual Enrollment Period (AEP) (Oct 15–Dec 7) or the MA Open Enrollment Period (OEP) (Jan 1–Mar 31), though you may qualify for a Special Enrollment Period (SEP) if you move or have other qualifying life events, but be aware you'll need to get a Part D plan and might want a Medigap plan to help with costs. 

Why do people say stay away from Medicare Advantage plans?

Medicare Advantage offers extra benefits, but out-of-network care may be limited or costly. Other disadvantages include difficulty switching out of the plans later, restrictions on care access, and limitations on extra benefits.

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

What happens if you can't afford Medicare premiums?

If you can't afford your Medicare premium, you likely qualify for Medicare Savings Programs (MSPs) through your state's Medicaid office, which help pay premiums, deductibles, and coinsurance, or Extra Help, a federal program for prescription drug costs, with options like the Qualified Medicare Beneficiary (QMB) Program covering Part B premiums. Contact your state Medicaid agency or visit Medicare.gov to apply for these income-based programs for significant financial relief on your costs, including Part A/B premiums and drug plan expenses. 

What are the 5 things Medicare doesn't cover?

Medicare generally doesn't cover long-term care, most dental care, routine vision services (like glasses), hearing aids/fittings, and cosmetic surgery, though it does provide strong coverage for hospital and doctor services; you can often get coverage for these gaps through Medicare Advantage (Part C) or supplemental plans. 

At what age do you stop paying Medicare premiums after?

Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. See Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.

Do I need my Medicare card if I have a Medicare Advantage plan?

Yes, you need to carry your Medicare Advantage plan card, but you should keep your Original Medicare (red, white, and blue) card in a safe place at home; you'll use the Advantage plan card for doctor visits and prescriptions as it's your primary ID, but you might need the Original card if you switch back to Original Medicare or for certain services, so keep it safe for future use. 

Is there a penalty to switch from Medicare Advantage to original Medicare?

No, there's no direct penalty for switching from Medicare Advantage (Part C) back to Original Medicare (Parts A & B), but you risk significant issues: losing drug coverage (Part D penalty if you don't enroll in a separate plan) and potentially being denied or paying much more for a Medigap supplement due to medical underwriting after your initial guarantee period ends. You must switch during specific enrollment periods (Annual Election Period: Oct 15-Dec 7, or MA Open Enrollment: Jan 1-Mar 31). 

Is it better to have straight Medicare or a Medicare Advantage plan?

Neither Original Medicare nor Medicare Advantage (MA) is inherently "better"; the best choice depends on your health, budget, and lifestyle, with Original Medicare offering provider freedom and MA providing bundled benefits (dental/vision) and cost predictability via an out-of-pocket maximum, but often with network restrictions. Choose Original Medicare + Medigap for nationwide access and no networks, ideal for travelers or those wanting maximum choice, while Medicare Advantage suits those wanting all-in-one coverage (including drugs/extras like dental/vision) with lower upfront costs and a cap on yearly spending, provided they stay in-network. 

What is the biggest problem with Medicare Advantage?

The biggest disadvantage of Medicare Advantage (MA) plans is often the limited provider networks and restricted access to care, requiring prior authorizations, referrals, and potentially forcing you to switch doctors or travel far for specialists, creating barriers to timely treatment, especially for complex health issues, with potential for denials and mid-year changes. While MA offers extras like dental/vision, these networks can significantly limit choice and create hurdles for consistent, high-quality care compared to Original Medicare. 

Why are hospitals refusing Medicare Advantage plans?

Across the country, health systems report that Medicare Advantage's growing administrative burden — from denied authorizations to delayed reimbursements — has become unsustainable. Some hospitals have already ended their contracts; others are limiting participation to only a few select plans.

Why are people opting out of Medicare Advantage plans?

People are leaving Medicare Advantage (MA) plans due to difficulty accessing care (like provider network limits, prior authorizations), dissatisfaction with care quality, issues with plan generosity, and challenges with specific plans, especially as their health needs grow, often leading them back to Original Medicare for broader choice but sometimes finding it hard to switch. Healthier individuals might join for perks, but sicker enrollees often face network restrictions, approval hurdles, and poor experiences, prompting disenrollment, notes KFF and ElderLawAnswers. 

What is better, a medicare supplement or advantage plan?

Neither is inherently "better"; it depends on your health, budget, and preference for flexibility vs. extra benefits, with Medicare Supplements (Medigap) offering freedom to see any doctor (higher premiums, fewer benefits) and Medicare Advantage (Part C) bundling benefits (dental, vision, drug) with network restrictions and lower premiums but potential costs like copays/prior approvals. Choose Medigap for predictable costs and broad access, or Advantage for lower upfront costs and added perks. 

What is the 7 month rule for Medicare?

This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

Is Medicare changing in 2025 for seniors?

In 2025, the biggest Medicare changes for seniors focus on Prescription Drug coverage (Part D) with a new $2,000 annual out-of-pocket cap, eliminating the "donut hole," allowing monthly payments for drug costs, and introducing price negotiations, while Medicare Advantage plans face potential benefit adjustments, and Part B premiums and deductibles will increase. Expect some MA plans to reduce extra perks to offset new drug costs, plus updates to telehealth and integrated care options. 

Why do they push Medicare Advantage so hard?

Medicare Advantage (MA) plans are heavily promoted because private insurers profit significantly from government payments, offering appealing extras like dental, vision, and fitness perks not in Original Medicare, and using aggressive marketing (like celebrity endorsements and extensive ads) to attract enrollees who switch from traditional Medicare, creating a lucrative, competitive market despite potential issues with provider networks and claim denials. 

What does Dave Ramsey say about Medicare?

Dave Ramsey's Medicare advice centers on planning ahead, understanding enrollment periods to avoid penalties, using Health Savings Accounts (HSAs) if possible, and supplementing Original Medicare with Medigap or Medicare Advantage (Part C) to cover gaps like dental, vision, and long-term care, stressing that mistakes can be costly and recommending expert advice for personalized choices.