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TOP 5 REASONS TO CHOOSE ORIGINAL MEDICARE WITH A MEDICARE SUPPLEMENT PLAN
Michael T. Braden September 25, 2026 MEDICARE PLANS
YOUR FIRST BIG DECISION WHEN JOINING MEDICARE
Did you know that when you first enroll in Medicare, whether you do it when you turn 65 or continue working under your employer's group health care plan, you have a 7-month window to enroll in any Medicare Plan you choose? This is known as your INITIAL ENROLLMENT PERIOD, or your IEP.
During your IEP, there are three options for Medicare coverage:
1. Original Medicare
2. Original Medicare with a Medicare Supplement or Medigap plan
3. Medicare Part C (Medicare Advantage Plans)
ORIGINAL MEDICARE
Original or Traditional Medicare is a straightforward Healthcare plan in which Medicare (CMS, the government) pays 80% of your healthcare services, and you are responsible for the remaining 20%. Highlights of Original/Traditional Medicare include coverage where you live, and you can receive services from any Doctor at any hospital in the US and all U.S. territories. This includes teaching hospitals such as Cedars-Sinai, Johns Hopkins, Mayo, Barrow Neurological, etc.
Nationwide, just under 94% of all doctors accept Medicare. Doctors who accept Medicare have agreed to the Medicare payment scale for medical services.
Original Medicare combines Medicare Part A (Inpatient Hospital Services, Skilled Nursing Facilities (SNF) and Medicare Part B, which covers your outpatient services like Doctor visits, Imaging, Physical and Occupational Therapy, Lab and Diagnostic services, and some B Medications that can only be administered in a doctor's office or Hospital.
Medicare Part A has no deductible, and the annual Part B deductible is $283 in 2026.
The doctors who most typically do not accept Medicare are:
· Pediatricians
· Psychiatrists
· Psychologists
· Naturopathic Doctors
· Homeopathic Doctors
If you want to be in charge of your own healthcare, not some autocrat at an Insurance company, then Original/Traditional Medicare is the best option for you, hands down.
Note: Original Medicare does not offer Prescription Drug coverage, so those who opt for Original/Traditional Medicare will need to enroll in a stand-alone Medicare Part D Prescription Drug plan. Nationwide, Medicare beneficiaries will typically have 7-12 Medicare Part D plans to choose from.
ORIGINAL MEDICARE WITH A MEDICARE SUPPLEMENT/MEDIGAP PLAN
If you like Original/Traditional Medicare, you will love adding a Medicare Supplement or Medigap plan. First, Medicare Supplements and Medigap mean the same thing, so don't let that confuse you.
You will choose a Medicare Supplement/Medigap plan that best suits you, your family, and your lifestyle. You will pay a separate Monthly premium to the Medicare Supplement/Medigap Insurance company you choose to partner with, and they will assume the risk and payment for the 20% share leftover from Original/Traditional Medicare.
Currently, the top four Medicare Supplement/Medigap plans in the country are Plan F (only available to those who were 65 or older before January 1, 2020), Plan G, Plan N, and High-Deductible Plan G. Once you choose a Medigap/Medicare Supplement Plan, your plan will never be canceled for any reason other than non-payment of your monthly premium for 90 days. Can your premiums go up? Yes, but not because of your claims history. Let's say you have chosen a Medigap Plan N as your Medicare Supplement/Medigap plan. If your Insurance partner applies to the state for a premium increase, that increase covers everyone in your state with the same lettered plan. So, a 6% increase would mean everyone in your state with a Medicare Supplement/Medigap Plan N would receive the increase.
11 standardized Medicare Supplement/Medigap plans are available nationwide. Every Lettered Medigap/Medicare Supplement plan carries the same benefits in all 50 states, and like Original/Traditional Medicare, coverage is good in all 50 states and all U.S. territories. Prices for Medicare Supplement plans and which plans are available in each state are determined by your State Department of Insurance and the insurance carriers.
With Original Medicare, you go to any Doctor that accepts Medicare. The doctor bills Medicare directly. Medicare will see if you have a Medicare Supplement/Medigap plan, and they will send a notice to your Medigap/Medicare Supplement carrier to pay their share from any/all services you received after your annual deductible has been met. You do not have to do anything.
MEDICARE PART C (MEDICARE ADVANTAGE PLANS)
Medicare Part C was originally called Medicare Choice. Medicare Choice is rarely used anymore; they just refer to Medicare Part C as Medicare Advantage. Different for-profit insurance companies offer these plans across the country, and plans and premiums vary by state.
Because Medicare Advantage plans are not Medicare plans per se, they can offer additional health coverage that is not available through Original/Traditional Medicare. These extra benefits can include Routine Dental, Vision, and Hearing benefits, as well as monthly gym memberships. Most Medicare Advantage plans (MA Plans) also include Prescription Drug Coverage (MAPD). For most members, Medicare Advantage plans won't pay for your medications, but they will offer prescription drug coverage.
Medicare Advantage Plans come in a variety of flavors, if you will. Here are the types of Medicare Advantage plans:
· HMO Plans. HMO(Health Maintenance Organization) plans are the most restrictive plans, and they force you to only receive services from doctors and facilities that are in your plan's network. With an HMO, you are only covered in the county you live in, and your only options if you are outside of your county are to use an urgent care facility or receive services from a hospital Emergency Room.
· PPO Plans. PPO plans (Preferred Provider Organization) are typically more flexible; you may designate a PCP, but you can usually make an appointment with specialists in the plan's network without needing to go through your PCP or pay a referral fee. Most PPO plans give you access to out-of-state PPO providers in the plan's nationwide network. Most PPO plans have better and longer-tenured providers than HMO plans.
· SNP Plans. Special Needs Plans (SNP) are designed to serve members with specific Special Healthcare Needs. These plans typically incorporate a multi-level care approach using a care team.
· CSNP Plans. Critical Special Needs plans offer specific, targeted care for those who have been diagnosed with chronic health issues, such as heart disease, kidney disease, and ALS. Many people may have Chronic Respiratory challenges, but most CSNP plans require a member to have either Chronic Heart Disease, Chronic Kidney Disease, or ALS to qualify.
· MA Only Plans. These are Medicare Advantage plans that do not include coverage for Prescription drugs. These are typically great options for Veterans who have qualifying Prescription Drug coverage through the VA.
Medicare Advantage plans work much like most Employer Group Health plans, where you typically go to your Primary Care Provider (PCP) to receive services or to get a referral to see a specialist. You have co-pays and coinsurance fees for everything from office visits to Imaging, Lab work, physical therapy, occupational therapy, medical equipment, hospital rooms, etc.
Every Medicare Advantage plan has its own designated MOOP (Maximum Out-of-Pocket) amount that you will need to reach before the plan will pay for all of your healthcare costs for the remainder of the calendar year.
With Medicare Advantage, you choose a new plan every year. If your plan isn't available next year, you'll need to choose a new plan. It's also very difficult to switch back to Original/Traditional Medicare with a Medicare Supplement/Medigap plan if you have had Medicare Advantage. This is because of the Medical Underwriting questions that you must pass to qualify for a Medigap/Medicare Supplement plan. These plans are only guaranteed during your IEP, unless you live in a state that has a Medicare Supplement/Medigap Birthday Rule in place.
NOW, LET'S TAKE A CLOSER LOOK AT THE TOP 5 REASONS THERE ARE FOR CHOOSING ORIGINAL MEDICARE WITH A MEDICARE SUPPLEMENT PLAN OVER MEDICARE ADVANTAGE (MEDICARE PART C)
COMPARING COSTS
To receive Medicare Benefits, either from Original Medicare or from Medicare Part C (Medicare Advantage), you must be enrolled in Medicare Part B. In 2026, the monthly premium for Medicare Part B is $202.90. So, everyone must pay at least $202.90 each month.
From there, things change dramatically. With Original Medicare, you pay all costs up to $283.00. That is the Annual Medicare Part B deductible. After you reach your Part B deductible of $283, Medicare will pay 80% for all covered services, and you are responsible for the other 20%. But if you have chosen a Medigap (Medicare Supplement) plan, it will usually pay your 20% share. You do this by paying a separate monthly premium for this coverage. But that is it; you will not be nickel-and-dimed to death by copays and coinsurance.
If you remember the old FRAM Oil Commercials in the 70s, they showed a Mechanic suggesting you pay him now to install a new Oil Filter, or pay him a lot more later when the engine gives out. It is also like the adage: an ounce of prevention is worth a pound of cure. With Original Medicare and A Medicare Supplement/Medigap plan, your Guaranteed Not To Exceed costs are simply your monthly premium. Let's say you chose Plan N, with a monthly premium of $110. You will spend $1,320 on Premiums for the year, plus the $283 Part B Deductible. Your maximum out-of-pocket for the year is $1,603. Your monthly budgets are consistent, so you don't need to worry about unexpected Healthcare costs.
With a Medicare Advantage Plan, it depends on what the MOOP (Maximum Out-of-Pocket) amount is for your particular plan.
The nationwide average MOOP for Medicare Advantage plans in 2026 is $5,760, with some plans over $12,000! If you are healthy, you may not have any costs, but since only regular X-rays are free, you will likely have expenses in most years. A Hospital stay is about $400 per night; an MRI or CT scan costs between $350 and $500, and Cancer Treatments all come with a 20% Coinsurance amount.
TOP 5 REASONS TO CHOOSE ORIGINAL MEDICARE WITH A MEDICARE SUPPLEMENT PLAN
GUARANTEED FOR LIFE
Everyone has a one-time opportunity to enroll in a Medicare Supplement or Medigap plan without answering health questions or declaring their health history during your 7-Month Initial Enrollment Period (IEP). Once you have your plan, it is yours for life unless you stop making your premium payments for 90 days.
YOU CONTROL YOUR HEALTHCARE, NOT YOUR INSURANCE COMPANY
You can see any Doctor who accepts Medicare in the US and go to any hospital in America.
You have no networks; you do not need to have a PCP, and you are really in charge of your healthcare.
Another major factor in staying in charge of your own Healthcare is that if something happens, it doesn’t matter; you can never have your Medigap/Medicare Supplement plan canceled. If you have Medicare Advantage and you have to have a procedure done, a pacemaker installed, Stents implanted, received a Cardiac scare, went through cancer treatments, have been diagnosed with dementia or Alzheimer’s, you will not pass underwriting for a Medigap/Medicare Supplement Policy. So don't be penny-wise and pound-foolish; get a Medigap policy during your IEP and enjoy life!
SAY GOODBYE TO PRIOR AUTHORIZATIONS
Perhaps the worst part of having a Medicare Advantage plan (Medicare Part C) is that your Insurance company alone determines if and when they approve a particular test or procedure. They can tell you that you need Prior Authorization before any procedure, test, or surgery is performed, unless you want to pay for it out-of-pocket, and if that is the case, why have a Medicare Advantage plan in the first place? Medicare Advantage plans are famous for doing this, especially at the end of the year in the 4th quarter. Why at the end of the year? Simple, because they know you have to pick a new plan every year, and if they keep the money in their pockets, their profits go up.
With Original/Traditional Medicare, a doctor attests that any recommended procedure is “Medically Necessary,” and that is it.
PREDICTABLE COSTS AND EASY BUDGETING
With Original Medicare, you have an extremely low deductible for Part A, No Deductible for Part B, and Reasonable plan and premium options to enhance your coverage and lower your risks by adding a Medicare Supplement/Medigap plan to Original Medicare. You won't have to worry about networks or surprise healthcare costs. And you have peace of mind knowing you are 100% covered anywhere in the United States!
Note: If you have had or visited anyone in a Skilled Nursing Facility while recovering and rehabbing after a Hospital stay, you know some facilities are awesome, and some, quite honestly, are just old and run-down; the food and service stink, and it is just not a good vibe. If you have Original Medicare, you pick whatever facility you want to go to. Your dollar goes farther, and there is no charge for Physical or Occupational Therapy. With Medicare Advantage, you typically are limited to 8-10 Physical Therapy appointments with a $25 copay, and after that you pay full price for any additional appointments.
NO NEED TO CHANGE PLANS YEAR TO YEAR
If you choose Original Medicare and you purchase a Medigap policy or a Medicare Supplement plan, you are set. Your plans continue month after month, year after year. There is nothing to do; you do not need to change plans; your plan can never be canceled; and because they are standardized, your plan has the same benefits in every state.
With Medicare Advantage, you have to choose a new plan every year. Who wants to do that year after year?
WRAPPING THINGS UP
I hope today’s article about the Top 5 reasons you should choose Original Medicare with a Medicare Supplement/Medigap plan over any Medicare Advantage plan was interesting and that it helped you understand some of the major differences between Original Medicare and Medicare Advantage (Medicare Part C). I've seen sad things happen to very nice people simply because they tried to get by on the cheap for a few years, only to find that perhaps the worst thing that can happen in retirement, besides getting older, is realizing you are not in control of your own healthcare. You have no say in who you see or where to go.
Please let us know if you found this article interesting and helpful in understanding future Medicare Part D price increases. Please email me directly at mike@bradenmedicare.com or call me at (480) 225-1393.
You can also call Medicare directly with questions at 1-800-MEDICARE (1-800-633-4227) or visit the Medicare.gov website to start a live chat. TTY users should call 1-877-486-2048.
