What's the most cost-effective way for a healthy 65-year-old to structure their Medicare coverage?

Question

David Koller · Accepted Answer

It all depends on your situation and needs.  Most senior beneficiaries save money by enrolling in a Medicare Advantage Plan in their area but that may or may not be what is best for them specifically.

William Lawler · Answer

Enroll in a Medicare Advantage plan that has prescription drug coverage, vision, dental and hearing coverage for a low or no monthly premium. There is a maximum-out-of-pocket (MOOP) per year which differs with each plan.

Answered by William Lawler on April 7, 2025

Broker Licensed in MO, FL, IA & 12 other states

Answered by William Lawler Medicare Insurance Agent

Andrew Zurbuch, MBA · Answer

Examine a Medicare Advantage plans in the part of your State of residence. Medicare Advantage plans are build with local networks. Go with a Policy that has the hospital & doctor or doctors Innetwork & covers your prescriptions if you take any prescription. You can opt out of Medicare Advantage plan within the first 12 months if it was the first time you purchased a  Medicare Advantage plan. Please use a Broker. Thank you.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Steven Graves · Answer

Great question! For a healthy 65-year-old looking for cost-effective Medicare coverage, the goal is balancing affordable premiums with enough protection to avoid big surprise bills.

Here’s a common, cost-effective approach:

1. Original Medicare (Part A & B)
Part A is usually premium-free if you’ve worked enough

Part B has a standard monthly premium ($170.10 in 2024)

2. A High-Value Medigap Plan (Like Plan G)
Covers nearly all out-of-pocket costs except the Part B deductible

Predictable costs—usually a higher monthly premium but no surprise bills

Great for peace of mind against unexpected hospital or doctor costs

3. A Standalone Part D Prescription Drug Plan
Choose a plan with good coverage for your medications

Premiums vary, but you can shop annually for better deals

4. Skip Extras You Don’t Need Yet
Since you’re healthy, you may not need dental, vision, or hearing coverage right away

You can add these later if needed via standalone plans or Medicare Advantage

Why This Works:
You avoid high out-of-pocket costs with Medigap’s broad coverage

You keep monthly premiums manageable

You maintain freedom to see any doctor who accepts Medicare

You can tailor drug coverage to your needs and budget

Would you like help comparing Medigap and Part D plans available in your area to find the best value?   Call us at Medicare4USA.com    214-989-7900

Paul Potter · Answer

Depends on your needs.  I would want to know if you have VA benefits or some employers benefits to start.  Next, I want to know which plans cover your doctors and how much they charge for your drugs.   Finally I like to compare the options so you can see the plans so you can make an informed decision.  

If you would like to get help with these steps, please send an email to me at PaulPotter@Email.com or text me at 321-346-9996.  I would be happy to help.

Luke Rhoads · Answer

I would say the most cost effective way to structure medicare coverage is Medicare Advantage Prescription drug plan with ancillary plans like hospital and critical illness to supplement the co-pay gaps.

Answered by Luke Rhoads on July 15, 2025

Broker Licensed in OK

Answered by Luke Rhoads Medicare Insurance Agent

Randall Taylor · Answer

The advice from a knowledgable Medicare Specialist is the best way to find out since everyone's situation is different and Medicare is changing all the time. I want my clients to have the most coverage for the least amount out-of-pocket.

Answered by Randall Taylor on April 7, 2025

Broker Licensed in TX, MI & WI

Answered by Randall Taylor Medicare Insurance Agent

Justin Sonon · Answer

Longterm, I believe having a Medicare supplement plan, paired with a separate dental and vision plan is the most cost effective way to structure your Medicare coverage. 

If you're willing to have cost sharing through deductibles, copays and coinsurance, and are willing to deal with network restrictions, Medicare Advantage plans can also offer a cost effective way to structure your Medicare. 

What you need to realize is that if you start out with a Medicare Advantage plan and later down the line want to switch to a supplement plan years later, you'll be subject to medical underwriting, which puts you at risk of being declined for pre-existing conditions.

Cassandra Mancuso · Answer

The most cost-effective Medicare set up is typically Medicare (part A& B) paired with a low or zero premium Medicare advantage ( part C ) plan that includes built-in part D prescription coverage. These plans often offer low monthly costs, including dental/vision, perks, and cap your annual out-of-pocket spending. However, you’ll usually need to stay in network and pay co-pays for services as you use them. This set up typically works best if you’re healthy, have predictable medical needs, and are comfortable with provider networks and some cost sharing.

Answered by Cassandra Mancuso on May 2, 2025

Agent Licensed in ME & NH

Answered by Cassandra Mancuso Medicare Insurance Agent

Kent Pike · Answer

That's totally on you. You could just to go with a Medicare Supplement or you could look at a Medicare Advantage Plan. It comes down to pretty much one thing, cost. Cost continue to rise for Medical Care, so finding a plan that fits your budget, and your needs is what needs to be done.

Answered by Kent Pike on May 16, 2025

Agent Licensed in NC, CA, FL & 6 other states

Answered by Kent Pike Medicare Insurance Agent

David Moore · Answer

Sit down with somebody like me review the doctors that you see the prescription that you may take the benefits of the companies and the overall cost then you can have the answer to your question.

Steven Bleicher · Answer

As long as your financial picture is in order, I am prejudiced in this regard. I've always been fond of the Medigap, a.k.a., the Medicare Supplement "G" plan. The rules of the G plan are developed by Medicare & cannot vary from state to state like the Advantage plan. So, you can budget for A) the Part B premium, B) the Part B $257.00 deductible, C) the Part D(rug) plan and D) the Medigap policy easily. They are simply more predictable and it covers emergencies which occur out of the country (within the 1st 60 days) when you are on vacation, up to $50.000.00 lifetime.

Answered by Steven Bleicher on May 30, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Valentina Gatewood · Answer

For a healthy Medicare recipient, the most cost effective might be a Part B give back plan. However we would want to compare it to you doctors and medications to confirm this would be a good fit.

Steve Brauer · Answer

If you are healthy, enrolling into a Medicare Advantage plan would be the most cost effective, since most plans are premium free. They would pay copays when they use services

Mike Henry · Answer

Depends on your financial situation. I’ve your well off get a high deductible plan.  Usually Plan G. Also when choosing your Part D get the plan that’s most cost effective. Premium versus benefit

Toni Chavez · Answer

Thanks for your question!

My professional opinion, get a Medicare advantage giveback plan to get the best of both worlds you get money back on your part B as well as in the event you need medical coverage you have that as well. Your out-of-pocket may be higher, but I always say cash is king.!

If you’re not using a broker, I recommend getting one. Our services are no cost to you, and we are able to look at your situation and recommend we are unbiased in regards to carrier selection..

Jaye Maxx Alexander II · Answer

The most cost-effective way for a healthy Medicare-eligible person is to research the best Medicare Supplemental plan. I would not recommend a MAPD or MA plan .

Tonya Mowan · Answer

There are many decisions to consider. However, you will still need to visit the Social Security office to complete signing up for Medicare regardless so that you do not have penalties. 

Questions to consider are: you are continuing to work, do I have credible coverage and how do I find out?, not retiring just yet, how can I delay enrollment?, Why do I have to complete this now?  

It is best to talk to an insurance agent that can assist you in the steps so that you have the best options for you. Each situation is different and your situation would need a conversation with someone so that you can understand the process for you.

Dominic Javier · Answer

The main components that affect the premium you pay periodically are deductible and coinsurance. Now, if you are healthy and strong at 65 or more, you may apply for a policy with larger deductible and larger coinsurance to decrease your premium. In that manner, you’ll address cost efficiency with lower premiums but higher copays since your frequency of checkups will be minimal to nil.

Answered by Dominic Javier on July 10, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Nicolas Johnson · Answer

The most cost-effective way you can structure your Medicare coverage would be to determine personally how much future use you would anticipate. There is no one answer for this question because everybody is different.

Answered by Nicolas Johnson on May 28, 2025

Agent Licensed in WI & IA

Answered by Nicolas Johnson Medicare Insurance Agent

Brian Loquist · Answer

If you are Healthy and would like to save money on Premiums, the Medicare Advantage Plan from Blue Cross Blue Shield is an excellent choice, as you have 3 years to move over to a Medicare Supplement Guaranteed Issue! other carriers are only 1 year.

Answered by Brian Loquist on May 13, 2025

Agent Licensed in SC, GA, NC & SD

Answered by Brian Loquist Medicare Insurance Agent

Nicolas Cain · Answer

For a healthy 65-year-old, Original Medicare plus a Medigap Plan G and a Part D drug plan is usually the most cost-effective setup.

Krystal Hampton · Answer

The most cost effective way for a health 65 year old to structure their Medicare coverage is to get a major policy and gap insurances to cover it. 

Gap insurances could be for hospital and doctor's copays and coinsurances or for dental, vision and hearing copays and coinsurances. 

So for a healthy 65 year old this could mean getting a Medicare Advantage policy with a gap insurance or getting a Medigap policy with a gap insurance. 

They would need to speak to a licensed Medicare agent to learn more about what other savings there could be as well.

What's the most cost-effective way for a healthy 65-year-old to structure their Medicare coverage?

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What's the most cost-effective way for a healthy 65-year-old to structure their Medicare coverage?

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