Yvette is 73 and has enjoyed the freedom of a Medicare Supplement plan for many years, but she no longer works and has been struggling to pay the premium. It started out reasonable, but with years of increases is now about $260 per month—an amount that Yvette finds a little uncomfortable. She does have some medical issues, but still thinks she’ll save money with Medicare Advantage.

Leaving a Medicare Supplement plan with no provider network was a worry to Yvette at first, but we were able to find a Medicare Advantage plan with all of her most important providers in network. The Advantage plan includes drug coverage, so she won’t need to pay separately for that, and it also includes dental, vision, and hearing benefits.

The monthly premium for her Medicare Advantage plan is $0 per month, and it has a $0 medical deductible and a $0 drug deductible. The Maximum Out-of-Pocket limit is $3,300 for Yvette’s plan, so if she ever spends this much on copays and coinsurance for Part A and Part B services during a calendar year, the insurance company will pay her remaining out-of-pocket costs for the rest of the year. (Maximum out-of-pocket amounts vary widely by county. The highest legal maximum in 2021 is $7,550 for an HMO and $11,300 for a PPO. Many counties have plans with lower out-of-pocket maximums than this.)

Considering her definite costs with the supplement were over $3300 per year, she feels good about switching to a plan that she’ll pay for as she uses. Getting the low max out-of-pocket limit is a comfort. If she has a terrible health year, then she’ll be spending no more than what she’d spend every year with her supplement. If she has a healthy year, then she will have low healthcare costs.

Medicare Advantage plans don’t allow the flexibility that Medicare Supplements do, but they make good financial sense for certain people in some geographic regions. Yvette understands that her new plan will not be as convenient or flexible, but her tighter budget necessitates the change.

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