Solve your health care challenges

A growing number of seniors in recent years have opted to enroll in a private Medicare Advantage plan rather than the traditional government program. The draw: For an average of $40 to $74 more a month over the regular Medicare premium, you usually get a host of extra benefits. But starting next year, Uncle Sam will cut fees to the insurers that administer the plans, prompting concerns that some will exit the market, hike premiums, or slash benefits.

The solution: You can reduce the risk that you'll get socked by big changes to your plan by sticking with an Advantage plan that's been around for at least five years and, if available, earns four or five stars from the government (check ratings at medicare.gov). That's because starting in 2012, top-rated plans will get a bonus from the feds that will offset some of the fee cuts. Plus, if your insurer alters the plan, you'll get advance warning, and will be able to switch out during open enrollment, before the changes go into effect.

Usually, though, if you have serious health problems, travel a lot, split time between two homes, or just want to see any doctor you choose, you're better off with traditional Medicare. That's because you generally have to stick with doctors inside the Advantage network or, if the plan allows, pay more to see an outside provider. If you go the traditional route, you'll probably want to buy Part D drug coverage and a Medigap policy to help pay your deductibles and co-insurance. Together those plans often have higher premiums than Advantage, but you'll pay less out of pocket if you fall ill.

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