The Medicare Question Every Boca Raton Retiree Asks Me
“Yvonne, should I choose Medicare Advantage or a Supplement plan?” I hear this question almost daily from retirees here in South Florida. And honestly? There’s no one-size-fits-all answer. But after 8 years of helping people navigate Medicare, I can help you figure out which one fits YOUR life.
Let me break this down in a way that actually makes sense.
First, Let’s Clear Up the Confusion
Original Medicare (Parts A & B) is like having a house with no roof. It covers a lot, but there are gaps – like that 20% you’re responsible for with no limit. That’s where these two options come in:
Medicare Advantage = Replaces Original Medicare entirely
Medicare Supplement = Works alongside Original Medicare
Think of it this way: Medicare Advantage is like trading in your car for a different model. Medicare Supplement is like keeping your car and adding premium features.
Medicare Advantage: The All-in-One Option
Medicare Advantage plans are popular here in Boca Raton, and I understand why. Many of my clients love that everything’s bundled together – hospital, medical, and usually prescriptions, plus extras like dental and vision.
What my clients love about Medicare Advantage:
- Often $0 monthly premium (you still pay Part B)
- Includes prescription coverage
- Extra perks like gym memberships (hello, fitness centers!)
- Annual out-of-pocket maximum (peace of mind)
- Dental, vision, and hearing coverage
The reality check:
You’ll need to use their network of doctors. If your cardiologist at Boca Regional isn’t in-network, you’ll need to switch or pay more. And yes, you might need referrals to see specialists.
Medicare Supplement: The Freedom Plan
Medicare Supplement (or Medigap) is like having a VIP pass to healthcare. You can see any doctor in the country who accepts Medicare – no networks, no referrals, no hassle.
Why my snowbird clients often choose Supplements:
- See any doctor who accepts Medicare (that’s 98% of them)
- No network restrictions – perfect for travel
- Predictable costs with minimal surprises
- Coverage works the same in Boca or Boston
- Your benefits don’t change every year
The trade-off:
Higher monthly premiums (think $200-400/month) and you’ll need separate prescription coverage. No extras like dental or vision either.
Real Stories from Your Neighbors
Last month, I helped Maria from East Boca. She’s healthy, plays tennis three times a week, and wanted to keep costs low. We found her a Medicare Advantage plan for $0/month that includes her prescriptions and even covers her eye exams. She’s thrilled.
But then there’s Robert, who splits time between Boca and Michigan. He has a heart condition and sees specialists regularly. For him, a Medicare Supplement Plan G made sense. Yes, he pays $285/month, but he can see his doctors in both states without worry.
The Money Question (Let’s Talk Real Numbers)
Medicare Advantage typical costs:
– Premium: $0-50/month
– Doctor visits: $10-30 copay
– Specialists: $40-50 copay
– Maximum out-of-pocket: $3,000-7,500/year
Medicare Supplement typical costs:
– Premium: $200-400/month
– Doctor visits: $0 after Part B deductible
– Specialists: $0 after Part B deductible
– Maximum out-of-pocket: Just the Part B deductible ($240 in 2024)
Which One Is Right for You? Ask Yourself These Questions
1. How important is keeping your current doctors?
If you’re attached to specific doctors, check if they’re in Medicare Advantage networks. With a Supplement, this isn’t even a question.
2. Do you travel or live in multiple states?
Snowbirds and travelers often prefer Supplements. Medicare Advantage can work, but you’ll need to check coverage areas.
3. What’s your health situation?
Frequent doctor visits? Complex health issues? Supplements offer more predictability. Pretty healthy? Medicare Advantage might save you money.
4. What’s your budget comfort zone?
Can you handle a higher monthly premium for peace of mind? Or would you rather have lower premiums with the possibility of higher costs if you get sick?
The Timing Thing Nobody Tells You About
Here’s crucial info: When you first get Medicare, you can choose either option. But if you pick Medicare Advantage first and later want to switch to a Supplement, you might have to answer health questions. They could say no or charge you more.
Going from Supplement to Advantage? No problem – you can do that during any fall enrollment period.
My Honest Take for Boca Raton Retirees
After helping hundreds of local retirees, here’s what I’ve noticed:
Medicare Advantage works great if:
– You’re staying local (love that Boca lifestyle!)
– You’re relatively healthy
– You want those extra benefits
– You’re comfortable with managed care
Medicare Supplement shines when:
– You travel frequently or have homes elsewhere
– You have specific doctors you won’t give up
– You want maximum flexibility
– You prefer predictable costs
Don’t Make This Decision Alone
Look, I know this feels overwhelming. When I first started in insurance, even I found Medicare confusing! But here’s the thing – you don’t have to figure this out by yourself.
I’ve helped hundreds of Boca Raton retirees find the right fit. Whether that’s a Medicare Advantage plan that includes your Boca Regional doctors or a Supplement that travels with you to see the grandkids, we’ll find what works for YOUR life.
Ready to Make Sense of Your Medicare Options?
Let’s have a real conversation about your needs, your doctors, and your lifestyle. No insurance jargon, no pressure – just honest guidance from someone who’s been in your shoes.
Call me at 954-646-3666 or email yheaven@aol.com. I’ll help you understand your options and feel confident about your choice.
P.S. Turning 65 soon? Don’t wait until the last minute. Let’s talk at least 3 months before your birthday so you have time to make the best decision without rushing.
Yvonne Heaven has been helping Palm Beach County retirees navigate Medicare since 2016. When she’s not simplifying insurance, you’ll find her enjoying our beautiful South Florida weather on her kayak or the pickleball court.
