Over the years, I have spoken with many people who would prefer to pay more per month to have the protection of knowing they will never get a big bill. Those folks typically purchase a Medigap Plan to work with Original Medicare, avoiding "big" bills. But what does "big" mean? Well, "big" has a different meaning depending on your financial situation.
According to a recent survey by the National Institute on Retirement Security, 40% of older Americans live solely on their Social Security income alone, which is challenging. Given that, it stands to reason that as of 2024, more than 50% of retirees have chosen Medicare Advantage plans to provide their coverage since most plans do not require an additional monthly premium.
Although these plans keep monthly costs lower, there is potential for larger copay events like inpatient hospitalization, an ambulance ride, weeks of physical therapy, etc. In many cases, these events cause people already living check to check to choose whether they get the healthcare they need, pay their bills, or buy food. Or, after a medical emergency, they have no choice but to get a payment plan and try to budget those payments.
What if There Was Another Option?
What if an insurance product could handle those larger copays and bring protection to Medicare Advantage enrollees for a small additional monthly premium that, on average, is only 20% of the cost of a Medigap Supplement policy? What if the benefits of these plans were completely customizable – you choose and pay for only the benefits that you feel you need? What if, between the ages of 64 ½ to age 68, you didn't have to answer any medical questions and were guaranteed approval?
I know, I know, you are saying, "That just sounds too good to be true." But it's not. Here's an example for a 65-year-old:
- Plan pays $200 per day for up to 7 days for hospital confinement
- Plan pays $250 per occurrence up to four times per year for an ambulance ride
- Plan pays $50 per day for up to 15 days of outpatient rehabilitative therapy (physical, speech, etc.)
- Plan pays $250 per outpatient surgical procedure up to twice per year
- Plan pays $150 per occurrence for an emergency room visit
- Plan pays $175 per day for mental health confinement
- Plan pays a short stay benefit for observation services
How much do you think this protection is worth? Personally, I feel it is PRICELESS… but is it affordable? You tell me. The monthly cost for the example above is $27.88 per month – less than any payment plan you might be set up on to cover the copays on a larger medical event. There are plans as low as $6 per month, depending on what you want them to cover for you.
If you have a Medicare Advantage plan and want more protection without breaking the bank, give us a call and schedule a meeting with your Retirement Advisor – we are always here to make your journey 123Easy.
By American Retirement Advisors
American Retirement Advisors helps retirees and pre-retirees navigate Medicare, estate planning, and retirement income — so you can enjoy the retirement you've earned.
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Easy Eddie's Take
This article talks about something called Medicare supplement insurance for Medicare Advantage plans, and it's worth understanding how this fits into your 2026 Medicare options. Most people know about Medigap policies that work with Original Medicare Parts A and B, but these newer supplemental products are designed specifically for Medicare Advantage enrollees who want extra protection against those unexpected copays and deductibles.
Here's what a lot of people don't realize: Medicare Advantage plans have annual out-of-pocket maximums set by the Centers for Medicare & Medicaid Services – for 2026, that maximum can't exceed $8,850 for in-network services. But reaching that limit through hospital stays, emergency room visits, or ongoing physical therapy can still create a real financial strain for folks living on fixed incomes. These supplemental plans help cover those gaps with fixed daily or per-occurrence payments, which makes budgeting much more predictable.
The guaranteed acceptance period mentioned in the article is particularly valuable because it means you can get coverage without medical underwriting if you apply during that window. That's pretty unusual in the insurance world and can be a real lifesaver for people with health conditions who might otherwise be declined for coverage. A little extra protection today can prevent a lot of financial stress down the road.