Is Medicare Better Than Individual Plans?

Reviewed and Updated by Anastasia Iliou,

Are you turning 65 soon and preparing to switch from your individual marketplace plan to Medicare? Or are you eligible for Medicare but trying to decide if you want to keep an alternative form of coverage? Generally, there are four types of health care plans and it can be hard to figure out which one you need. Your options are employer coverage, private coverage, Medicaid, and Medicare (additionally, Tricare and VA coverage for Veterans). Some people can have more than one of those options at any given time.

Let’s talk about the differences.

Employer Coverage

You can purchase health insurance through your employer, as long as it meets the coverage limits set by the federal government.

Private Coverage

You can purchase insurance from an exchange like, directly from your state, or directly from a health insurance company. Generally, purchasing private insurance is more expensive than employer coverage, and much more expensive than Medicare and Medicaid.


Medicaid is a federal health program. Each state has slightly different rules and each state has its own funding. It can cover any person of any age with low income (according to the Federal Poverty Level). Most Medicaid beneficiaries will have either no or very small premiums. If you have a low monthly income AND are over 65, you may qualify for both Medicaid and Medicare!


Medicare is a federally funded health program for adults with disabilities, end-stage renal disease, or kidney failure. It also covers any person over the age of 65. Some parts of Medicare are free, while others require premiums. Most people will not have to pay nearly as much for Medicare as they would with an individual or private health plan.

You may think that individual plans provide more coverage due to the higher premiums, but that is not always the case. All Medicare plans include preventative services. Plus, you can choose to enroll in Medicare Advantage, which is like a private plan for Medicare. With Medicare Advantage, you can roll all your benefits – medical, dental, vision, prescription drugs, and even fitness – into one convenient plan.

We specialize in Medicare and serving the underserved senior and Medicare-eligible population. Do you or a loved one need help selecting a Medicare plan that truly helps? Set up a free appointment with one of our licensed agents in your area to get bias-free assistance. Call us to set it up at 1-844-431-1832.

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Step 2. Find Plans With Confidence


Step 2. Find Plans With Confidence


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Step 3. What is Your Preference?

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