How To Make the Best Insurance Decisions for Your Health
Phoenix Home Care & Hospice is committed to helping you live well at home. Our dedication to you includes providing guidance on Medicare, so that you have the healthcare coverage you need for daily life as well as the unexpected.
Get To Know Original Medicare
Your Initial Enrollment Period in Medicare starts three months before your 65th birthday and three months after, giving you a seven-month window to enroll.
Everyone who enrolls starts with what is known as Original Medicare — Parts A and B:
- Part A, your hospital insurance, is typically free for most people, outside of those with high incomes, who pay a premium.
- Part B, your medical insurance, is deducted as a premium from your Social Security benefits.
However, Medicare Parts A and B don’t cover all of your healthcare costs. To ensure coverage of medical expenses and access to providers, you have a choice to make: Medicare Advantage or Medicare Supplemental Insurance, called Medigap.
Important Dates: The Medicare Advantage Annual Enrollment Period (AEP) runs October 15–December 7 each year. During this time, you can switch between Original Medicare and Medicare Advantage, or change plans. There’s also a Medicare Advantage Open Enrollment Period, January 1–March 31, for people already in an Advantage plan to change Advantage plans or return to Original Medicare.
Why Choose a Medicare Advantage Plan?
- No premium: Although you’ll still pay your Part B premium through Social Security, these plans often have a $0 premium.
- Out-of-pocket maximum: Your annual in-network costs are capped, which helps with budgeting.
- All-in-one coverage: This plan bundles Parts A, B, and often Part D to include limited dental, vision, hearing, fitness, or over-the-counter allowances.
Find out more about the upcoming enrollment period here.
Why Choose a Medicare Supplement Plan Instead?
Medigap, the Medicare supplement, steps in to cover costs after Parts A and B. Medigap provides distinct benefits that help make care convenient and affordable for you:
- Access: Get care from the provider of your choice, anywhere in the United States.
- No prior authorization: Your provider can choose your care without prior authorization required by a Medicare Advantage plan. (Keep in mind that in 2026, certain states will require prior authorization for certain procedures.)
- No copays or deductibles: You pay a premium for Medigap, yet you won’t have these additional expenses to manage.
- 100% coverage: With Medigap and Medicare Parts A and B, you have complete insurance coverage.
Get more information on Medicare Supplement Insurance here.
What To Consider Before You Make Your Selection
Medicare Advantage and Medigap have their pros and cons. Before you decide, take a look at these insights that are meant to help you make the best choice for your insurance coverage and care.
Think About Your Budget
A primary difference between Medicare Advantage and supplemental Medicare is how it hits your wallet. Although some may prefer paying a premium for supplemental coverage, others may find paying a copay or deductible through Medicare Advantage more cost-effective for their budget.
There’s Only a Short Window To Cancel Your Medicare Advantage Plan
You also have to consider what may happen if your Medicare Advantage plan doesn’t end up meeting your needs. When you enroll in Medicare Advantage, you only have one year to switch to supplemental Medicare coverage without getting a health screen.
Why does this matter? After one year, you are subject to a health screen prior to enrollment in Medigap coverage, and that health screen could potentially reveal a condition that makes supplemental insurance cost-prohibitive. You don’t want to wait until you’ve had a health scare to try to switch from your Advantage plan.
Although “extras” like fitness allowances or dental and vision may be nice, consider choosing a plan that also considers your future health, even if you’re doing well now.
Medicare Advantage Rewards and Incentives Change Year to Year
You should also know that many of the rewards and extras that traditionally come with your Advantage plan will be scaled back in 2026. This includes perks such as preloaded debit cards for eligible expenses or gift cards for taking healthy actions, like getting your flu shot.
Ads About Medicare Advantage Can Be Confusing
As we age, we begin to notice that we’re targeted with a new kind of advertising: Medicare ads. Many Medicare Advantage ads make consumers feel like they’re missing something without an Advantage Plan.
Ensure you’ve looked at all the facts about your Medicare Advantage plan without relying on emotionally persuasive advertising. You may be better suited for a Medigap policy. Keep in mind that ads can be misleading, and that it’s better to get counsel from a resource that isn’t trying to sell you a plan.
Where Do I Go for Questions and Concerns About Medicare?
It can be difficult to navigate Medicare alone. Your best resource when you have questions about Medicare is the State Health Insurance Assistance Program (SHIP), which offers free and unbiased counseling to choose a plan that meets your needs.
Contact your state’s SHIP program as you begin to make decisions to ensure your health insurance needs are met:
