My kids keep telling me to get a Medicare Advantage plan, but my friends say stick with Original Medicare. Who should I listen to?

Question

Cynthia Nakaya · Accepted Answer

Original Medicare has deductibles and co-insurance and doesn't include drug coverage-part D (If you don't have a PDP- Prescription Drug Plan-and haven't had one for over 63 days after your initial enrollment period has passed, you'll pay a lifetime penalty when you sign up.) With original Medicare, you can go to any doctor who accepts it.

In 2025, part A has a $1,676 deductible. You pay:
Days 1–60: (of each benefit period): $0 after you meet your Part A deductible ($1,676).
Days 61–90: (of each benefit period): $419 each day.
After day 90: (of each benefit period): $838 each day for each lifetime reserve day (up to 60 days over your lifetime).
After you use all of your lifetime reserve days, you pay all costs.

There's a term here, "benefit period". The benefit period lasts for 60 days. If you are out of the hospital for over 60 days, the process starts over, and you pay the deductible again (lifetime reserve days do not start over).

Part B has a $257 deductible, with generally a 20% co-insurance after it's been met. Original Medicare has no maximum out-of-pocket. If you are in the hospital multiple times during the year, the costs can be financially devastating. 

Medicare Advantage plans have maximum out-of-pocket limits built into their plans. Depending on where you live, there are both HMOs and PPOs to choose from. HMOs require referrals to see specialists. PPOs are more flexible but costs for out-of-network doctors are higher. 

Another option is Medicare Supplement, which works with original Medicare. If you choose this option, you need a stand-alone PDP. Knowing this information should help you decide who to listen to- your children or friends.

Lt Col Tim Brown · Answer

Original Medicare only pays 80%. So if you had a $30,000 out patient surgery and only had Medicare, your co-pay is $6,000. Under a medicare advantage plan it is (depending on the company) $270 to $300. Yes, Original Medicare is costly. I agree with your kids as I and my wife chose a medicare advantage plan.

Answered by Lt Col Tim Brown on May 9, 2025

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

Answered by Lt Col Tim Brown Medicare Insurance Agent

Norman Smith · Answer

Everyone’s situation is different so to speak exactly as to your individual situation is hard to do.
Generally, if you have the means to do so, and afford a Supplemental carrier plan, there is no better coverage then Original Medicare with a top Supplement offered in your state. This allows you to control your health, and have access to the best doctors, hospitals, facilities, and professionals within the medical community anywhere in the country at any time. For that you will have your Part A, B (which is $185/mo. and can be paid through your SSI) and the premium for your Supplement. You will also have a Part D Prescription plan that can be a $0-180 Premium per month. For the G plan here in Florida (the best plan) you are looking on average between $200-$230/ month.  Unless it is a concierge doctor, 98% of Doctors accept this payment across the country.
For MA plans, you will have either a PPO, HMO, or PFFS plan, and will be limited as to your choices as you will generally have to stay in their networks. Your major specialty hospitals will not accept MA plans - examples: John’s Hopkins, Mayo Clinic, Cleveland Clinic, etc. Most plans require you to pick up the Part B still, and you may still have Co-pays, Co-Insurance, and deductibles. You will also have a MOOP and then the policy can apply. So be careful here. They may offer “gifts” and “freebies”, which make it front loaded for benefits, but where you really may need them is the backend, and we can’t be sure when that is for any of us! 
Remember: Price is what you pay, Value is what you get, and Cost is what it is when paid the wrong price to get the wrong value! - so be careful as this is the ONLY TIME you will choose with no Underwriting involvement, and you can be sure that your health with age cannot ultimately improve, but have more challenges! Good luck!!!

Tony Capraro III · Answer

Someone who deals with helping clients with Medicare planning every day! Get the facts-not the hype! Work with someone who can explain the "medicare alphabet soup" so it's easily understandable and who also sells both: Medicare Supplement/Medigap AND Medicare Advantage! We can go over all the Pros and Cons of each plan and with staying with Original Medicare!

Answered by Tony Capraro III on April 7, 2025

Agent Licensed in NH & ME

Answered by Tony Capraro III Medicare Insurance Agent

Steven Graves · Answer

That’s a really common dilemma, and both your kids and friends have good points! The truth is, the best choice depends on your personal health needs, lifestyle, and budget—not just what others recommend.

Why Your Kids Like Medicare Advantage:
Often comes with $0 premiums

Includes extras like dental, vision, hearing, and fitness benefits

Bundles medical and drug coverage in one plan

Feels more convenient and modern to younger generations

Why Your Friends Prefer Original Medicare + Medigap:
Offers freedom to see any doctor who accepts Medicare, nationwide

Medigap covers most out-of-pocket costs, so bills are more predictable

No networks, referrals, or surprise restrictions

Often better for people with ongoing or complex health needs

What Matters Most Is What Fits YOU:
Do you want lower monthly costs or predictable out-of-pocket expenses?

Are your doctors in Medicare Advantage networks?

Do you travel frequently or live in multiple states?

How important are additional benefits like dental or vision?

Bottom line:
Listen to both, then focus on what fits your situation best. If you want, I can help you compare plans based on your health, doctors, and budget—so you can make a confident choice that works for you.

Would you like me to help with that?   Call us at Medicare4USA.com  214-989-7900

Richard Moreno · Answer

It depends on your needs and also if you are able to pay 20% of all services covered by Medicare. You will need to get a medical plan to help cover the 20% but you need to be able to afford the premium which increase with age

Answered by Richard Moreno on May 31, 2025

Broker Licensed in TX, FL, LA, NM & OH

Answered by Richard Moreno Medicare Insurance Agent

Marsha Reiniers · Answer

The plan you choose is totally your choice, not your kids, and not your friends and neighbors. Both types of plans have their advantages and disadvantages. Be sure to take the time to understand exactly how both these approaches to your healthcare work, and then you can make your own educated decision about what is best for you.

Answered by Marsha Reiniers on April 7, 2025

Agent Licensed in FL, GA, NC, PA, SC & VA

Answered by Marsha Reiniers Medicare Insurance Agent

Mark Bilgere · Answer

This is a dilemma a lot of people face. Although our friends and families are well intentioned, they are often uninformed about the different aspects of Medicare and Medicare options. The best option is to find a local Medicare broker that represents several carriers. Schedule an appointment and ask your kids or neighbor to tag along. Then everyone can be on the same page. No two people are exactly the same when it comes to their health needs, medications, budget, family history, past medical needs, future living and travel plans and long term care needs. An experienced broker will gather information to help you decide on a plan that is best for you.

Answered by Mark Bilgere on July 21, 2025

Broker Licensed in TX, AR, IN & LA, MN, NE & OK

Answered by Mark Bilgere Medicare Insurance Agent

Brady Kidwell · Answer

You should honestly listen to your gut. But me personally I’m leaning more towards a Medicare advantage plan. Here is why, with original Medicare you’re still responsible for 20% of the coverage. so let’s say you have a $50,000 hospital bill, so roughly that would leave you with a $10,000 bill. Most Medicare advantage plans only have a max out-of-pocket of no more than $5000 which depending on which area you are located in..

Answered by Brady Kidwell on June 4, 2025

Broker Licensed in TN, FL, GA & KY, NC, SC & VA

Answered by Brady Kidwell Medicare Insurance Agent

Wade Lashley · Answer

Ultimately it's a choice you have to make yourself. Other people's opinions can be helpful but how much do they really know about Medicare? There are pros and cons to both options. If your uncertain as to which is the right choice for your needs I'd recommend contacting a Local Agent to clarify the differences between the two so that you can make an informed decision.

Answered by Wade Lashley on July 1, 2025

Broker Licensed in AZ

Answered by Wade Lashley Medicare Insurance Agent

Steven Bleicher · Answer

It's so funny that when your car breaks down, you go to the expert, your great mechanic! But when your kids tell you something as important as your HEALTH! you are not being coached by an expert but one who most likely only hears bits and pieces of a hearsay conversation.+ It seems to me that your friends are closer to your age and my suspicion is that they may know juuuusst a little bit more about one’s healthcare! So, pick up Parts A & B, a Medicare Supplement plan and a Part D(rug) Stand-Alone plan please, as long as it is affordable and if you may have a few health issues to be covered, too.

Answered by Steven Bleicher on June 4, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

Choosing between Original Medicare and Medicare Advantage can be confusing, especially with conflicting advice from family and friends. You should listen to yourself and make the decision that best aligns with your individual healthcare needs and financial situation. Neither option is inherently better than the other, and the right choice depends on your specific circumstances.

Answered by Diana Garner on June 26, 2025

Broker Licensed in KY, FL, IN, OH & TN

Answered by Diana Garner Medicare Insurance Agent

Steve Houchens · Answer

You should talk with an agent or someone that knows and understands both options. Both are good and just different. The most important thing is to understand fully the differences and choose which is best for you. I don't believe in a one size fits all approach. Know your options and choose from there.

Answered by Steve Houchens on July 12, 2025

Agent Licensed in KY & TN

Answered by Steve Houchens Medicare Insurance Agent

Barbara Barnes, CMIP® · Answer

You should decide for yourself because only you know what your priorities are.

There is no single right answer for which is best between Meficare Supplement and Medicare Advantage. Both work well in their specific ways.

Medicare Supplements use Original Medicare as the base for coverage and Original Medicare allows you to see any provider in the country that accepts Medicare. Medicare Supplement plans generally have less managed care, so they are also easier to use when your doctor wants you to receive treatment ents or to have tests done. Generally, the premium is higher for a Medicare Supplement, but the claims cost is lower. But Supplements do not include ’extra’ benefits like dental, vision or hearing benefits.

Medicare Advantage plans usually require that you see a network provider to receive the higher benefit amount. Some plans will only pay when you see providers who are in network. Advantage plans are also known for managing care to save money, so your doctor will need to have most tests and treatments approved before they take place. You will have a copayment for every service you receive in an Advantage plan, up to a plan-specific out-of-pocket maximum. Generally, premiums are lower (maybe even $0) for Medicare Advantage plans, but claims are higher. Most Medicare Advantage plans do include ‘extra’ benefits, but those benefits vary by plan year and insurance company.

In summary, it is important that you understand all of your options before you make a decision. You should consult with a local Medicare insurance agent before you make a final choice. Your family and friends mean well, but they cannot advise you as well as a licensed insurance agent on this issue.

Steven Lovell · Answer

You should listen to a medicare specialist to help determine your financial needs, your health care concerns and who's gonna pay the ultimate bills in the future. If something was to happen to you, your friends unfortunately are not experts and your children may be responsible for paying the bills making the decision for you that may not be in your best interest.

Answered by Steven Lovell on May 10, 2025

Broker Licensed in GA, CA, FL & 7 other states

Answered by Steven Lovell Medicare Insurance Agent

Ron Cronwell · Answer

Speak with a licensed and knowledgeable local insurance agent who will you take into account your specific situation and coverage needs. The decision is not only a financial one. Family health history, your health history, peace of mind, financial, availability of medical services in you area are a few of the consideration that go into making a educated decision. What is great for another person in a different location may not be the same for you.

Answered by Ron Cronwell on July 26, 2025

Agent Licensed in TN

Answered by Ron Cronwell Medicare Insurance Agent

Shelly Hefley · Answer

Each person is different and I look at financial situation and Health. If you’re in bad health and can’t afford a supplement then that might be the way to go…. But if you’re financially struggling, there are a lot of good advantage plans that may save you money and give you some extra benefits

Answered by Shelly Hefley on April 9, 2025

Broker Licensed in IN, AL, IL, KY & TN

Answered by Shelly Hefley Medicare Insurance Agent

Melanie Blackston · Answer

When you are looking into a Medicare Advantage Plan versus Original Medicare, it's normal to receive conflicting advice from many different sources. Both plans have their own advantages and disadvantages, but the best choice for you will depend on your individual needs and preferences.

Answered by Melanie Blackston on July 9, 2025

Broker Licensed in SC, GA & NC

Answered by Melanie Blackston Medicare Insurance Agent

Jeremy Henry · Answer

This is tough because we talk with friends and family to get different perspectives which is natural, however I would tell anyone in this situation to try to look at it from a neutral perspective, at least as much as you can.

When I sit with a client we go over what I call a "Medicare 101". My goal is to educate my client on these two options by going over the pros and cons of both. That way in the end they can make an educated decision on what is best for them.

Czarida Leyco · Answer

Hi, I suggest you work with a licensed Medicare agent in your state who can properly educate you in the difference between Original Medicare, Medicare Advantage and Medicare Supplement. By being informed and educated about Medicare in all its aspects, you will be better prepared to make the best Medicare plan that suits your needs.

Answered by Czarida Leyco on July 30, 2025

Broker Licensed in NC, MA, ME, NY & SC

Answered by Czarida Leyco Medicare Insurance Agent

Steve Brauer · Answer

Since Medicare is not a "one size fits all", you should listen to your Independent Medicare Broker. We are trained and hopefully knowledgable about the industry and products in your area. In my opinion, you MUST find someone that only does Medicare, since you can't be an expert at everything.

Answered by Steve Brauer on April 16, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

Carol Thompson · Answer

I would say not to listen to neither. If you want an opinion then get a professional opinion from an insurance broker/agentand it’s Free! 

The role of an insurance broker is as such: each and every year we have to be tested for the changes of Medicare  laws/ guidelines and go through training to know the changes of the plans as they can change yearly. Seek professional help- often times
I have saved people quite a bit per year.

Suzanne Lamperti · Answer

Original Medicare is a better choice if you don't have specific or chronic issues. Medicare Advantage us more limited, you can't go to a doctor or specialist of your choice. If you do, they normally won't cover. If you travel, Originall Medicare is a better choice. Medicare Advantage is more restrictive.

Answered by Suzanne Lamperti on April 11, 2025

Broker Licensed in MD

Answered by Suzanne Lamperti Medicare Insurance Agent

Toni Chavez · Answer

Thanks for your question! I would listen to either I would recommend speaking to a licensed broker who can review your Sutton and recommend options based on your specific needs. Friends & Family are great, but when it comes to you health and options having a licensed professional assist is the best course of action.

Answered by Toni Chavez on June 22, 2025

Broker Licensed in AZ, CA, NM, NV & UT

Answered by Toni Chavez Medicare Insurance Agent

Linda Davies · Answer

Your choice should align with the benefits you need and out-of-pocket expenses you are willing to pay.

Original Medicare does not cap out-of-pocket expenses, and does not cover additional benefits like dental, vision, and hearing.  

Medicare Advantage does cap out-of-pocket expenses.  This means that after you have paid a certain amount out-of-pocket, you won’t pay anything else for the rest of your plan year.  This max out-of-pocket expense is set by your plan.  

Also, Medicare Advantage covers additional benefits that Original Medicare does not, as mentioned, like dental, vision, hearing and more.

Tony Merwin · Answer

I would advocate listening to your friends as they actually have experience being Medicare recipients themselves.

What reasons are your kids recommending a Medicare Advantage plan?

Sonya Chandler · Answer

You have to do what's best for you.  As everyone's situation is different.  I would explain the Medicare Advantage Plans and Original Medicare and help you to make an informed decision.

Leisha Stevens · Answer

Hello, That's a very common question, and both your kids and friends have valid points to consider! The best choice for you depends on your individual needs and preferences. Review Medicare Advantage plans and see which one includes your doctors and medication. 
Here is more information:
Original Medicare
Includes Part A (Hospital Insurance) and Part B (Medical Insurance).
Administered by the federal government.
Provider Network: Allows you to see any doctor or hospital in the U.S. that accepts Medicare.
Referrals: Generally, you don't need a referral to see a specialist.
Prescription Drug Coverage: Doesn't include prescription drug coverage (Part D), so you'd need to purchase a separate Part D plan or choose a Medicare Advantage plan that includes it.
Out-of-Pocket Costs: Doesn't have an out-of-pocket maximum.
Extra Benefits: Doesn't cover routine vision, hearing, or dental care.
Travel Coverage: Provides coverage throughout the U.S. Generally doesn't cover medical care outside the U.S., 
Medicare Advantage plans can offer lower premiums, may include prescription drug coverage and extra benefits like vision and dental care, and has an out-of-pocket maximum to limit your spending. However, you'll need to stay within the plan's network for most care and might need referrals for specialists.

Tanja Roulhac · Answer

Choosing between Original Medicare and a Medicare Advantage plan depends on your personal health needs, preferences, and circumstances. 

Original Medicare (Part A and Part B)
Coverage: Hospital insurance (Part A) and medical insurance (Part B).

Flexibility: You can see any doctor or specialist that accepts Medicare without needing a referral.

Costs: You pay premiums for Part B, and typically deductibles and coinsurance for services.

Additional Coverage: You may need to buy a separate Part D plan for prescription drugs and/or a Medigap policy for extra coverage.

Medicare Advantage (Part C)
Coverage: Includes everything Original Medicare covers plus often additional benefits like vision, dental, hearing, and sometimes prescription drugs.

Network: Generally requires you to use a network of doctors and hospitals; may require referrals for specialists.

Costs: Often lower premiums than Original Medicare + Medigap, but you might have copayments or coinsurance with each service.

Extra perks: Some plans offer fitness programs, transportation, or wellness benefits.

Who to Listen To? You decide what is best for you.  I am available to assist with Part D carriers or if you choose a Medicare Advantage, I will assist you with choosing the carrier that best meets your needs.

I hope this helps.

Tanja Roulhac,
Licensed Medicare Broker

Christopher Stewart · Answer

You should listen to you and your needs. Choosing between original Medicare with a supplement and a drug plan vs choosing to go with a Medicare Advantage Prescription Drug Plan is 100% based on each individual's needs. You need to have a well versed and well-educated broker that can and will review all of your options and give you the answers to your questions that will help you decide which route is best for you.

Answered by Christopher Stewart on July 7, 2025

Broker Licensed in FL, AL, AZ, CO & KS

Answered by Christopher Stewart Medicare Insurance Agent

Jessie Rhodes · Answer

My first response would be to listen to your kids but then I would recommend finding an Agent who could explain to you the the difference between the two and then I would also recommend doing an needs analysis to determine which option is best for you.

Answered by Jessie Rhodes on July 30, 2025

Agent Licensed in TX, AL, AR & 23 other states

Answered by Jessie Rhodes Medicare Insurance Agent

Dennis Sullivan · Answer

Having an Advantage plan is beneficial for the benefits outside of original medicare. For instance, vision, dental, hearing. There is also an option to get a part B buyback to alleviate costs associated.

Answered by Dennis Sullivan on June 27, 2025

Agent Licensed in FL

Answered by Dennis Sullivan Medicare Insurance Agent

Jeremy Watson · Answer

Your coverage is YOUR coverage. It should be tailored to your specific health needs and situation. Speaking to a professional who can help you understand the pros and cons of both types of coverages, costs, networks, and advising based on your personal circumstances is ideal. Choosing a coverage based on "hear say" or "blind suggestions" may have consequences down the road.

Answered by Jeremy Watson on July 30, 2025

Broker Licensed in IN, FL, KY & MI, OH, SC & TN

Answered by Jeremy Watson Medicare Insurance Agent

Donald Baker · Answer

Every circumstance is different. You should meet with a licensed insurance advisor to discuss your individual situation, .

Edward Wooten · Answer

I would recommend sitting down with a Medicare professional and work together selecting a plan that works best for you! Many factors come into play so ask questions to know how that plan will fit your needs. Ask your family and friends why they suggest one over the other and discuss those concerns when speaking to your agent. They all love and care for you but select the option that is in your best interest!

Answered by Edward Wooten on July 21, 2025

Broker Licensed in IL & MO

Answered by Edward Wooten Medicare Insurance Agent

Christian Marti Del Campo · Answer

That’s a great question — and one that many people wrestle with. Whether Medicare Advantage or Original Medicare is better depends on your personal health needs, budget, and lifestyle. 
For better understanding of your options reach out a professional to help guide you through the process

Renee Pena · Answer

The best choice for you depends on your personal health needs, financial situation, and preferences. That's a benefit of having a trusted agent to discuss your specific circumstances to get tailored advice.

Answered by Renee Pena on May 15, 2025

Broker Licensed in TX, CA, CO & 12 other states

Answered by Renee Pena Medicare Insurance Agent

Patrick Lohrey · Answer

Listen to your friends. They probably have friends who have experienced many of the pitfalls associated with owning Medicare Advantage. Your kids probably listened to Joe Namath on those phony Medicare Advantage TV adds.
The reality is you don't get health care for free - not even Medicare. If you want narrow provider networks owned by insurance companies, then select Medicare Advantage. If you want roughly 70% of the services you receive, requiring prior authorizations by the insurance company which allows them to respond by saying, "Not medically necessary," then select Medicare Advantage. If you need major surgery and end up spending 5 days in the hospital, which requires you to pay at least $1,500 out-of-pocket, then take Medicare Advantage.

I could go on. So, give me a call to follow up and to help you select a solid Medicare Supplement Plan. You can put an end to the argument and feel good about your choice. My number is 717-968-9300. _Patrick

My kids keep telling me to get a Medicare Advantage plan, but my friends say stick with Original Medicare. Who should I listen to?

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My kids keep telling me to get a Medicare Advantage plan, but my friends say stick with Original Medicare. Who should I listen to?

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