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Real members of myRAteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

In your experience with Medicare after 65, do you prefer a supplemental with Medicare plus drug plan. or do you prefer a Advantage Plan?

A myRAteam Member asked a question 💭
Utah

I turn 65 next month. Right now I have an advantage plan, but I am seriously thinking of getting a supplemental with drug plan. I have so many medical bills this year with the changes on my advantage plan. I have extremely high cost meds and infusion.

April 10
 · 
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Answer Summary

Members turning 65 shared their experiences choosing between Medicare Advantage plans and traditional Medicare with a supplemental plan, with... Read more

Members turning 65 shared their experiences choosing between Medicare Advantage plans and traditional Medicare with a supplemental plan, with many leaning toward traditional Medicare plus a supplement for those with complex, high-cost conditions. Several members noted that while Advantage plans work well for healthier individuals due to lower premiums and added perks like dental and gym memberships, those with expensive medications, infusions, or serious illnesses often faced high out-of-pocket costs and coverage limitations. A recurring theme was the value of consulting an independent broker or Medicare navigator to compare plans based on your specific doctors, medications, and health needs before making a decision.

A myRAteam Member

Carol2015 Hi. Do not know if anyone told you this but you need to go on Part D of Medicare b/c if you don;t and decide you want it later you will be out of luck. You cannot add it later. You need to have it all along.

April 12
A myRAteam Member

For me, my most expensive RA drugs are covered under Part B. But that is not true of all medications. We elected to go with an AARP Supplemental plan. Plus a Part D.

April 10
myRAteam

What's the best Medicare option for someone with RA on expensive medications and infusions?

Choosing between Medicare Advantage and Medicare with a supplemental plan (Medigap) plus Part D is a personal decision that depends on your specific situation. Since you're dealing with high-cost RA medications and infusions, here Show Full Answer

What's the best Medicare option for someone with RA on expensive medications and infusions?

Choosing between Medicare Advantage and Medicare with a supplemental plan (Medigap) plus Part D is a personal decision that depends on your specific situation. Since you're dealing with high-cost RA medications and infusions, here are some key considerations:

Medicare with Supplemental (Medigap) + Part D may offer:
- More predictable out-of-pocket costs since Medigap plans help cover copays and deductibles
- Greater flexibility to see specialists without referrals
- No network restrictions for doctors and hospitals
- Potentially better coverage for expensive biologics and infusions

Medicare Advantage plans typically have:
- Lower monthly premiums but potentially higher out-of-pocket costs when you need care
- Network restrictions that may limit provider choices
- Annual out-of-pocket maximums (which can still be substantial)
- Varying coverage for expensive medications

Given that you're experiencing high medical bills with your current Advantage plan and need expensive RA treatments, switching to Original Medicare with a supplemental plan and Part D drug coverage might provide more financial predictability. Medicare Part D offers Extra Help programs that can reduce prescription costs if you qualify based on income.

Your rheumatologist's office may also have insights about which plans work best with your specific medications and infusion centers. Additionally, connecting with other myRAteam members about their Medicare experiences could provide valuable real-world perspectives on managing RA treatment costs.

April 10
A myRAteam Member

Carol, I'm in Texas, but I used an independent agent that compared all the plans and takes a look at it every year to see if I need to make any changes. I have a supplement. Yes, it is expensive, but cheaper in the long run. The biggest change I had to make after 65 was moving to an infusion for my biologic. An infusion is considered a procedure and therefore covered better than a Rx.

April 14
A myRAteam Member

You can get it Linda, my husband was charged $3.00 a month more when he got it late.

April 13 (edited)

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