--- title: How I Talk to Clients About Their Medicare Options description: The Pros and Cons of the Different Medicare Options. Where is Your Risk Tolerance? Learn how to talk to clients about the key differences between Medicare Supplement and Medicare Advantage plans. image: https://at.naifa.org/hubfs/Elie%20Harriett%20Quote%20Box%20March%202025-1.png --- [![ApexNLC_banner2-1](https://at.naifa.org/hs-fs/hubfs/ApexNLC_banner2-1.jpg?width=728&height=73&name=ApexNLC_banner2-1.jpg)](https://apex.naifa.org/) [![Advisor Today Logo - White@960](https://at.naifa.org/hs-fs/hubfs/Advisor%20Today%20Logo%20-%20White@960.png?width=960&height=146&name=Advisor%20Today%20Logo%20-%20White@960.png) ![Advisor Today Logo - White@960](https://at.naifa.org/hs-fs/hubfs/Advisor%20Today%20Logo%20-%20White@960.png?width=960&height=146&name=Advisor%20Today%20Logo%20-%20White@960.png) ](https://at.naifa.org/) [![Join NAIFA](https://no-cache.hubspot.com/cta/default/2635471/19793afe-5adf-4f28-b999-9dd4527de76b.png)](https://cta-redirect.hubspot.com/cta/redirect/2635471/19793afe-5adf-4f28-b999-9dd4527de76b) [**](https://at.naifa.org/how-i-talk-to-clients-about-their-medicare-options#tmpmodule_1614584860767204) ** ![Lifesaver Beach-1](https://at.naifa.org/hs-fs/hubfs/Lifesaver%20Beach-1.jpeg?width=1400&height=799&name=Lifesaver%20Beach-1.jpeg) #### **NAIFA Members Provide Financial Security** ###### 4 min read ## [How I Talk to Clients About Their Medicare Options](https://at.naifa.org/how-i-talk-to-clients-about-their-medicare-options) By [Elie Harriett](https://at.naifa.org/author/elie-harriett) on 3/27/25 8:59 AM ###### Topics: [Retirement](https://at.naifa.org/topic/retirement) [Medicare](https://at.naifa.org/topic/medicare) ![](https://at.naifa.org/hubfs/Elie%20Harriett%20Quote%20Box%20March%202025-1.png) The most common question from a new client is, “Which do I get, Medicare Supplement or Medicare Advantage?” This is the speech I give every time, almost word-for-word. Unless you have work or retirement coverage available to you, there are only two options: a Medicare Supplement (also known as Medigap) or Medicare Advantage. There is no right answer, and there isn’t one company with a better option than another. Medicare Supplements are exactly the same in terms of their benefits. For Medicare Advantage, they’re pretty close, with a few important differences. But to make it easy to decide which is for you, you need to know the positives and negatives of each. And there’s really two positives, and two negatives for each one.  #### **The Positives of Medicare Supplements:** 1. You can take them to any doctor, any hospital, anywhere in the United States as long as those providers use Medicare, which is a great majority of doctors and hospitals. You don’t have to concern yourself with networks or state lines. As long as the bill gets to Medicare and Medicare approves the charge, the supplement pays its share (which, with most supplements, after the deductible, is 100% of the remaining bill). So if suddenly you need a new specialist due to changes in your health, you can find the best doctor available to you. Just make sure they bill original Medicare, schedule the visit, and go. No pre-approvals are needed. 2. What you buy in a Medicare Supplement is a traditional insurance policy with benefits guaranteed for life. So if your supplement is paying 100% of a hospital bill today in 2025, it will continue to pay 100% of that bill in 2045 as long as you still have the insurance. Short of the federal government altering the terms of what Medicare covers, you’ll have these benefits covered at this level for life. #### **The Negatives of Medicare Supplements:** 1. Medicare Supplements are traditional health insurance. And just like traditional health insurance, there is a premium. And the premium varies by company. And it is in addition to the Medicare Part B premium. And the premium will go up over time. Usually on an annual basis. Some years it will be a minor increase; others it will be larger. So, if you’re healthy, you’ll notice you’re paying more for Medicare Supplements than they’re paying for you, just like every other insurance you do not use when bad things don’t happen. It behaves just like your home, fire, and auto insurance. That will continue until something bad happens. So, expect to pay more per year in your healthy years than you see them paying for you. 2. Medicare Supplements do exactly what they are called, they supplement Medicare. No more, no less. If you get a bill Medicare approves, they pay. But if you get a bill Medicare does not cover, then the supplement won’t cover it either. Most dental isn’t covered. There’s no over-the-counter benefit, there’s no “healthy foods,” etc. You get pure health insurance. No more, no less. Factor that in when deciding. Those are the biggest good and bad considerations. The alternative to consider is Medicare Advantage (MA). And while there’s some slight variation on how MA plans work, they’re basically all the same. They have two positives and two negatives as well. And they’re actually the *opposite* of the supplement options! #### **The Positives of MA:** 1. Recall the negative of a supplement: they have a monthly premium which you pay regardless of how you use it. MA typically has either no or a very low monthly premium, depending on your state. That doesn’t mean you don’t pay anything, but it does mean if you don’t use it, you don’t pay (or pay very much) for it. So, you save money monthly on these plans. 2. Remember that Medicare Supplements give you nothing Medicare doesn’t give. Well, MA does. Medicare doesn’t cover dental, but many MA options give some of that to you. Many have an OTC benefit. If you have a chronic illness, they’ll maybe give you a free grocery option. Some have transportation options to and from a medical provider. So, there’s a bunch of extra options available to you with MA that supplements don’t give. #### **The Negatives of MA:** 1. Remember supplements allow you to go to any doctor, any hospital, anywhere in the U.S. that bills Medicare? Medicare Advantage is more restricted. Most are networked. There are primarily two types of networks, HMOs and PPOs. It’s my job to match your doctors with the insurance company as best I can, but if you need a new doctor or to change doctors mid-year, you are stuck in that system and have to find a provider that is part of the network. 2. Whereas Medicare Supplements are fixed in their benefits for life, MA needs to be reevaluated every year. They must cover everything Medicare does. But how much of it they leave you to pay can alter on an annual basis. What they give at no cost this year is allowed to be 20% of the cost next year. Most services on MA have a charge. So, when you are healthy, you pay very little (no services, no cost to you), but when your health changes and you have something serious, or if you develop a chronic health condition, you could pay more. There is a maximum out of pocket per person, but it resets every January and usually that maximum out of pocket is several times the cost of a Medicare Supplement premium. So, you save in your healthy years, but you spend more in your unhealthy years. The decision comes down to: Are you okay with medical networks and paying only when you are sick, but paying more if you become sick? Or do you want to go to whichever doctor you choose but are willing to pay a monthly premium for your coverage, potentially for the rest of your life, whether you use the insurance or not? There’s no right or wrong answer. Decisions must be based on each individual’s health, care preferences, and risk tolerance. That is my speech. I also talk about Medicare Part D, which is handled differently by both options. But due to the new out-of-pocket limit on Part D, I try to keep the decision based on risk tolerance on the medical side of things. *Elie Harriett, ChHC, has been a NAIFA member since 2004 and currently serves on the NAIFA National Government Relation Committee. 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