If you do decide to go with standard Medicare, pay for A, B, and D. That covers doctors, hospitals, pretty much everything else, plus drugs. The main advantage is that it's all portable: You can use any provider or hospital that accepts Medicare. The main disadvantage is the doctors or hospitals you want may not accept Medicare patients or have a moratorium on them because it pays so little.

I went with a Blue Cross MA plan, which just costs me the Plan B amount, and includes drug coverage equal to a Plan D. My provider is Scripps Clinic HMO, which is rated very highly in my state. The advantage is that they have every speciality I need with reasonable access, multiple levels of urgent care, ER care, great hospitals, and my same GP I had for the last 10 years. The disadvantage is it is not very portable: If I travel out of area, my billing goes up to be equivalent to the local Blue Cross negotiated rates. But I'm not planning to travel much.

My one beef is with every drug plan under Medicare: There is no cap. The last cost tier is just 5% of the retail price, but drug companies can charge anything they want for drugs that are under patent but cost them almost nothing to make. And they do: Tecfidera costs under $100 per year to make and they charge $72,000. 5% of that is several thousand per year. It's actually so easy to make, anybody could do it themselves with one organic chemistry course. And that's even legal until you try to sell it as the patented drug.


We're flying electric helicopters on Mars yet you can't turn on your clothes dryer in Texas. That's because scientists are in charge of Mars, and Republicans are in charge of Texas.