They're going to die.

[W_HAMILTON]

56. A distinction without a difference in the vast majority of cases.

For traditional Medicare to be most effective and cost-efficient, you need supplemental insurance.

If you start on traditional Medicare when you are eligible and sign up for a supplemental plan, I believe you cannot be turned down, your premiums are based on your age, and future premium increases are also tied to your age (rather than how sick you are/how much you utilize the insurance).

Contrast that with a Medicare Advantage plan, where once you are on it, you are most likely on it for life because you CAN be turned down if you switch back to traditional Medicare and try to buy a supplemental plan then. Your medical history will be used against you and even if you are the healthiest person on the planet, you are at least 65+. Think it was tough buying a plan on the individual market when you were in your 40s? Imagine that, but being aged 70, 80, etc. and almost assuredly with some health conditions that will result in you being considered a high risk.

I have dealt with this intimately twice now, when I was a caregiver for my mom and then when I helped my sister get connected with a Medicare broker to assist her in signing up.

DO NOT SIGN UP FOR MEDICARE ADVANTAGE.

Sure, it has a lot of added perks and other bells and whistles and seems great -- until you actually really need to use it. Like when someone has a stroke and they are in no shape to leave the skilled nursing facility they are currently in, but AI at a for-profit insurance company decided it's time to kick them out. Then you are left being a 24/7 caregiver for a bedbound stroke victim that can't do anything on their own.

No non-medical professional is ready for that and the last few months of my mom's life were made so much more difficult and stressful than they should have been. End-of-life is going to be tough regardless, but Medicare Advantage turned it into a nightmare.