Every year I stress over picking a plan and still end up surprised by the bills. Is there any way to just get peace of mind with Medicare?

Question

Tom Rogala · Accepted Answer

Change from medicare advantage to Medigap.  You will pay a monthly premium but never get a bill.  You can keep the plan forever and have peace of mind knowing your exact cost upfront

Larry Dalton · Answer

In my opinion, any time you deal with an insurance plan, you could be surprised by the billing procedures.  Medicare Advantage plans are underwritten by insurance companies, and they offer special incentives to help offset the inconvenience of using these plans.  

There should be no surprises when dealing with Medicare Part A and B. Medigap is mandated to follow the Medigap plan of your choice (A through N plans), and cannot deviate from these requirements.   However, Medigap plans require underwriting approval after the period that grants you the right to purchase such plans without any underwriting requirements.

Lt Col Tim Brown · Answer

Yes, First, don’t let this get to you. You need an Experienced agent. You can call me. I’m an agent and broker of 37 years. I help people with multiple plans and how they work. There is no need to have the frustrations you’re dealing with. I’m Tim Brown 615-506-9024

Answered by Lt Col Tim Brown on June 4, 2025

Broker Licensed in TN, AL, CO & 10 other states

Answered by Lt Col Tim Brown Medicare Insurance Agent

Mark Maliwauki · Answer

There is no such thing as a perfect Medicare plan. There is no such thing as a free lunch. 

Medical services cost money and from year to year sometimes month to month the needs of people change and the only thing you can do is match your current and / or short term needs with the best plan to meet those needs that is available right now.

You will always have to put some skin in the game. I firmly believe the future of Medicare and Medicaid is going to include more cost share from the member. Premiums, copays et al will have to go up.

Steven Graves · Answer

You're definitely not alone—Medicare can feel overwhelming, and it’s incredibly frustrating to try to make the “right” choice each year only to be hit with surprise bills anyway. The good news is: yes, there is a way to get peace of mind, but it depends on what peace of mind looks like for you.

 Ask Yourself: What Does Peace of Mind Mean?
Predictable costs?

Freedom to see any doctor?

No need to switch plans every year?

Extra benefits like dental and vision?

Once you define what matters most, you can build your Medicare around that.

 Here Are 3 Paths to Peace of Mind with Medicare:
1. Original Medicare + Medigap Plan G
Fixed, predictable costs: Only pay the Part B deductible ($240 in 2024), then Plan G covers the rest

See any doctor in the U.S. who takes Medicare—no networks, no referrals

Doesn’t change year to year like Medicare Advantage plans

 Best for people who want stability and maximum coverage with no surprises

2. A Strong Medicare Advantage PPO Plan
Includes medical, hospital, and usually drug coverage in one plan

Often $0 premium with added benefits (dental, vision, hearing, gym)

Some offer nationwide access (PPO), but you may pay more out-of-network

 Best if you’re healthy, want extras, and prefer simplicity in one plan

3. Work with a Trusted Medicare Agent Every Year
Instead of trying to do it alone, a good agent will:

Compare all available plans in your ZIP code

Make sure your doctors and prescriptions are covered

Help you avoid hidden costs and coverage gaps

 Best if you want expert help and hate doing all the research yourself

 Bottom Line:
Yes, peace of mind is possible—you just need a strategy that matches your lifestyle, and ideally, a guide you trust to help you through it each year.

Would you like help reviewing your current setup and seeing if there’s a more stable, lower-stress option for you?


Call us for help   Medicare4USA.com  214-989-7900

Kelsey Hentzen · Answer

I would highly suggest talking with a broker that understands your needs. With advantage plans, its good to add a hospital and cancer plan to cover most everything you might need.

Cynthia Nakaya · Answer

I'm sorry to hear you get more bills than you expect. Before choosing a plan, look at the Summary of Benefits, which tells you copay and coinsurance amounts. Copays are a set dollar amount (e.g. $10), while coinsurance is a percentage of the cost. Medicare Advantage plans also have an annual Maximum Out-of-Pocket (MOOP) so you know the most you have to pay for copays and coinsurance. Keep in mind this does not include Part D drug costs. If the Summary of Benefits doesn't have enough information for you, check your Evidence of Coverage (EOC) document, which goes over all benefits and costs. The EOC is usually sent out with your plan. If you didn't receive one, contact member services. Their phone number should be on the back of your membership card.

If you work with an agent, they should cover this during your annual review. If you get bills you weren't expecting, contact your plan or your agent to get answers. Sometimes billing departments make mistakes and send patients erroneous bills. This recently happened to one of my clients. We were able to contact the customer service department at her plan. They addressed the issue, and the plan paid the bill.

If you have any questions, please contact me!

Tammera Marrs · Answer

Medicare will pay 80% of Part A and Part B medical expenses, which does not include prescriptions. Purchasing a Medicare Suppplement picks up the 20% left from Medicare, but dependng on which plan you choose there could be out of pocket costs. Peace of mind comes when you are well versed in what you have purchased.

Answered by Tammera Marrs on May 19, 2025

Broker Licensed in KS

Answered by Tammera Marrs Medicare Insurance Agent

Ali Crouch · Answer

Yes, find an honest agent who will review the entirety of your plan each year. When I speak with my clients, I go over the details and everything they need to be aware of. No one likes surprises, so going over the details is very important.

Answered by Ali Crouch on April 10, 2025

Broker Licensed in NE, AZ, CO & 9 other states

Answered by Ali Crouch Medicare Insurance Agent

David Wiley · Answer

In my opinion, there are no surprises with a Medicare Advantage plan if you stay in Network.  With original Medicare and a med supp you sometimes encounter balance billing, which means you pay more.

Sandra Bailey · Answer

I am sorry to hear that.

If you have original Medicare, it pays 80% and Medicare Supplement/Gap pays 20%. There is a $257 deductible in 2025.  However, if you have cancer, there may be some out-of-pocket cost. Medicare pays for chemo but longer treatments may result in out-of-pocket costs. 

If you have a Medicare Advantage plan, some doctors and hospitals may come and go out of the network, which will cause you to shop each year.  Medicare Advantage plans also have deductibles, co-payments, coinsurance and maximum out-of-pocket expenses.  Before changing Medicare Advantage plans, please check your specific plan for these out-of-pocket costs.  Be sure you understand them so there won't be any surprises.  Ask your agent or broker to review your plan in detail with you.  You may also want to purchase a hospital indemnity plan to cover the hospital costs that Medicare Advantage doesn't pay.    

Hope this helps.

Kyle Kokot · Answer

Yes! Stick with one agent that is a broker and can offer all the options that are available to you in your area!

Corey Schuler · Answer

The easiest way to get peace of mind with Medicare, is by exploring Medicare Supplement plans. Medicare Supplement plans, aka "Medigap" plans charge you a monthly fee or "premium" to help you fill in the gaps of Original Medicare. These fixed costs help you budget for your healthcare and avoid financial stress that comes with large unexpected medical bills.

Answered by Corey Schuler on June 3, 2025

Broker Licensed in TX, AL, AR & 16 other states

Answered by Corey Schuler Medicare Insurance Agent

Steven Bleicher · Answer

I would love to tell you in a positive way but I would be lying to you. Due to the current administration, things are going to be more topsy-turvy than ever before. You should not have to stress on this every year unless you you have a (free of premium) Med. Advantage plan whose benefits can radically be altered from one year to the next. Had you chosen a Medigap or Supplement plan, the perks are defined by Medicare itself and won't be changed without legislation. However it is the government subsidized MA plans with a private Medicare-compliant insurance company who has the right to switch or delete the benefits at their own discretion but with the approval of CMS. It is likely that you won't qualify for a Medigap due to health reasons, I am so sorry to say. The only consideration I can think of, if you should move your official domicile to another state, you will be able to pick up the better Medigap plan because you are entitled to a “Special Election period” or SEP due to the move!

Answered by Steven Bleicher on May 25, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

If you are still surprised by the bills you receive, that tells me two things: 
1) You are more than likely on a Medicare Advantage plan
2) Whoever you are working with to sign up isn't explaining your benefits, copays, coinsurance, or deductibles clearly.

To ensure you fully understand the plan you choose to enroll in, it is best to work with someone who will explain everything to you.

If you are on a Medicare Advantage plan, there are plans called Hospital Indemnity plans that you can sign up for that will reimburse you for inpatient hospital stays, ambulance service, outpatient surgeries, and other specified benefits.

Michael Pyers · Answer

Have a Medigap plan.  Even though they have a premium, you will know what your out of pocket costs are!

Yasmery Vargas · Answer

Stability is key. Just because there's an annual enrollment period doesn't mean you have to shop for a plan every year. I recommend sitting with an agent and having a formal review of your plan. Shop your plan and include all doctors specialist and medications so you don't have to change every year.

Answered by Yasmery Vargas on April 18, 2025

Agent Licensed in PA

Answered by Yasmery Vargas Medicare Insurance Agent

DeeDee Whitlock · Answer

Best peace of mind is to find a local HONEST agent who looks at ALL your options & is willing to go over those options with you in detail

Michael Yost · Answer

I think it depends on what agent is helping you recommend plans. There are plans that can help lower your out of pocket expenses. There are plans that can help pay the medical bills. It's important to work with a broker that can explain all of your options in a way that you understand what you are enrolling in and what to expect.

Answered by Michael Yost on May 3, 2025

Broker Licensed in OH, AL, AZ & 27 other states

Answered by Michael Yost Medicare Insurance Agent

Cindy Clonts · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/every-year-i-stress-over-picking-a-plan-and-still-end-up-surprised-by-the-bills-is-there-any-way-to-just-get-peace-of-mind-with-medicare#cindy-clonts

James Stang · Answer

The costs of Medicare coverage are pretty straight forward. I always explain all the costs, from Part B premiums to plan premiums and copays. I would rather my clients be prepared for the worst and be surprised by not paying that amount.

Answered by James Stang on July 11, 2025

Agent Licensed in OH

Answered by James Stang Medicare Insurance Agent

Gary Henderson · Answer

Yes, if you're healthy enough, buy a Medicare supplement plan. You won't have any bills depending on the plan you choose. Plan g or n. You'll have the annual deductible which is $257 with plan n you get a little bit less expensive premium but you pay a $20 copay for a doctor. Visit $50 copay for an ER visit where you're sent home in 24 hours 
You don't have to worry about doctor bills with Medicare supplement plans, but you do have a monthly premium that you're going to pay

Mike Henry · Answer

You’re kind of at the mercy of Medicare. What may be covered by one company is no longer covered. That’s why you have to be careful. As always consult your advisor

Todd Bostic · Answer

Every year Medicare changes so much that it is hard to be certain that you can get peace of mind with Medicare.

Jaye Maxx Alexander II · Answer

To learn what is best for you is to engage a professional agent who is a broker. If you take the time to speak with a local or regional broker agent, they will design a plan just for you.

Ross Landon · Answer

That’s a tricky, one first determine where most of your medical bills are coming from, is that from RX cost, or is it from doctors and hospital visits? If you look back over the past year and determine that you’ll know how to approach a solution with a knowledgeable Medicare agent. It sounds like you are picking among Advantage  plans each year. They have a lot of co-pay dollar costs and coinsurance percentage costs if you use them frequently.  But they also have very low monthly premiums and often times even zero premiums. So those are desirable if you have lower medical costs and infrequent specialist and doctor visits.  

Medicare supplement plans, however, cover most all medical expenses, if you can afford the much higher monthly premiums, typically starting around $150 a month per person at age 65 and going up moderately each year from there. People like those that need predictable costs and can afford the higher premiums monthly, plus an Rx plan each.  You need guidance on picking the right kind of plan, and one that is affordable to you!

Wild Bill Anderson · Answer

Your desire to know how your plan will work is true of many we talk with. We serve over 1,500 Medicare clients who trust us to explain how plans will really work.  No big hidden “hammer” waiting to smash your wallet!
Medicare Done Right is what you want and that is who we are!

Bob Nunn · Answer

If possible I would contact a licensed professional agent to go over options and make sure you ask questions. A supplement with original Medicare might be a better option for you.

Robert Rowe · Answer

Yes of course. Working with an agent in person who is willing to always put your needs and your goals into your Medicare plan will bring lots of peace of mind. When it comes to eliminating bills, you are looking at Medicare Supplement or MediGap plans now because it seems you’d rather pay a monthly premium and not have to worry about paying any bills. If you’re set on Medicare advantage there are other ways to fill those gaps of coverage with alternative insurance policies like a hospital indemnity, accident and/or critical illness plan.

Answered by Robert Rowe on May 17, 2025

Broker Licensed in MI

Answered by Robert Rowe Medicare Insurance Agent

Kerwyn Jones · Answer

Yes! There a way of getting that done. A conversation with a competent Medicare Advisor will solve that problem

Kip Nussbaum · Answer

A couple of things to think about here. If you work with a competent and trusted broker, there shouldn't really be any "stress" over picking a plan. Usually upon comparing the costs and benefits of the available plans, most of them get weeded out on their own merit. The other thing is, you COULD choose to just purchase a Medigap or "supplement" plan (assuming you are able to qualify medically) and that avoids any of the "shopping" in the Fall. However, those plans come at a price as well. They all will have a monthly premium which, by the way, will increase every year due to your age. And you will most likely need to purchase a Part D drug plan which will still require some "shopping" every year. Just find a trusted broker who will treat you as a valuable client and not a number. This should eliminate most of your stress.

Answered by Kip Nussbaum on June 18, 2025

Broker Licensed in OH

Answered by Kip Nussbaum Medicare Insurance Agent

Jim Carroll · Answer

Absolutely. A Medicare Supplement Plan G covers 100% after you meet the $257 annual deductible. The reason this sounds so simple is because you are paying a monthly premium to a private insurance company. But, if you do the math, the 12 months of premiums are still less than the typical deductible and out-of-pocket maximums with a Medicare Advantage Plan. You can also add a Prescription Drug Plan usually a zero to little cost, depending on the Tier level of your medications.

Answered by Jim Carroll on May 5, 2025

Broker Licensed in FL, AL, GA & 9 other states

Answered by Jim Carroll Medicare Insurance Agent

Eric Jensen · Answer

The best way to have piece of mind is to speak with an independent insurance broker or agent and give him as much information as your can, such as your current presciptions and providers, as well as any upcoming changes you forsee such as pending procedures or Drs you may want to see over the next year.

That way the agent can more accurately forecast what coverage and plan would work best for your situation. Working with an independent agent, ensures that they are not beholden to only one carrier so they have the freedom to decide the best plan for you instead of trying to strear you to their employers plans.

Every year I stress over picking a plan and still end up surprised by the bills. Is there any way to just get peace of mind with Medicare?

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Every year I stress over picking a plan and still end up surprised by the bills. Is there any way to just get peace of mind with Medicare?

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