Medicare Advisor in San Marcos: Choosing Between a Supplement and Medicare Advantage
San Marcos has grown up fast. Families who moved to San Elijo Hills, Discovery Hills and the Twin Oaks Valley area twenty years ago are now the ones approaching 65, and the older neighborhoods around Lake San Marcos have long been home to retirees. Many of the people we talk to here have spent their careers on employer coverage and are now deciding what Medicare should look like.
That decision is the heart of a San Marcos Medicare conversation: Original Medicare with a Supplement, or a Medicare Advantage plan. Brian McArthur, creator of the Medicare Execution Process®, helps San Marcos residents and their financial advisors make that call with real numbers. Our Escondido office is just a few miles east on Highway 78.
Health care in and around San Marcos: Palomar and Tri-City nearby
- Palomar Medical Center Escondido: a short drive east, and a major hospital for inland North County.
- Tri-City Medical Center (Oceanside): reachable along Highway 78 toward the coast.
- Scripps and UC San Diego Health: further south, but often where people go for specialty surgery, cancer care or a second opinion.
Medicare Advantage plans use networks that vary by plan and year. Original Medicare with a Supplement lets you use any provider that accepts Medicare, including Palomar, Tri-City, Scripps and UCSD. Neither is right for everyone. The question is which doctors and facilities you actually rely on.
Leaving employer coverage at 65
If you have health coverage through work and you are turning 65, here is what to check:
- Initial Enrollment Period: seven months around your 65th birthday month.
- Employer size: if your employer has 20 or more employees and you are still actively working, you may be able to delay Part B without a penalty. Smaller employers usually expect Medicare to pay first.
- Retiree coverage: some employers offer a retiree plan. Compare it, including what it costs you, with the individual options before you assume it is the easiest path.
- Medigap open enrollment: six months starting with your Part B effective date, with no medical questions. If you are thinking of choosing a Supplement, this is the cleanest time to do it.
Original Medicare + Medigap vs. Medicare Advantage
Parts A and B come from the federal government. A Medigap Supplement, Part D drug plans and Medicare Advantage plans come from private insurance companies.
- Part B: $202.90/month standard premium in 2026, higher with IRMAA
- Plan G: pays what Original Medicare leaves behind, except the $283 Part B deductible
- Plan N: a lower premium in exchange for small office and ER copays
- Part D: a separate drug plan matched to your prescriptions
Medicare Advantage bundles hospital, medical and usually drug coverage into one plan with a network. It can suit someone who is happy with a single system and a primary care doctor coordinating care. Premiums, benefits and networks vary by plan and change yearly, so we compare the specific plans we offer in San Diego County against your doctors and medications.
IRMAA for San Marcos households
IRMAA surprises a lot of dual-income San Marcos couples, especially in the year after a business sale or a big stock vest. The 2026 Part B brackets for single filers are below. Married couples filing jointly use double the income thresholds:
- Up to $109,000: $202.90/month
- $109,001 – $137,000: $284.10/month
- $137,001 – $171,000: $405.80/month
- $171,001 – $205,000: $527.50/month
- $205,001 – $500,000: $649.20/month
- Above $500,000: $689.90/month
Your 2026 premium is based on your 2024 tax return. If your income has dropped since then because you retired, Form SSA-44 lets you ask Social Security for a lower bracket.
Working with your financial advisor
When a financial advisor is involved, Brian works with them so your Medicare choice fits the retirement income plan: which year you retire, when Roth conversions happen, and how that affects IRMAA. Your advisor gets a summary of what was placed and why. There is no fee-sharing arrangement.
Frequently asked questions
Should I choose a Supplement or a Medicare Advantage plan?
Medicare Advantage may be a good fit if you are happy with a network and a primary care doctor coordinating your care. If you want the option to see any provider that accepts Medicare, Original Medicare with a Supplement is the alternative. We lay out both side by side.
Can I switch later if I change my mind?
You can change Medicare Advantage plans or return to Original Medicare during enrollment periods, but buying a Supplement after your Medigap open enrollment window can involve medical questions. That is why the first decision matters.
Does Palomar Medical Center accept Medicare?
Palomar accepts Original Medicare. With Medicare Advantage, it depends on the plan’s network for that year.
My spouse is younger than me. What happens to their coverage?
Medicare is individual, so your spouse keeps their own coverage until they qualify. We plan both timelines together.
Do I need to come to the office?
No. Most meetings happen by phone or video, though our Escondido office is close by if you prefer to meet in person.
Book a 30-minute Medicare planning call
Turning 65 in San Elijo Hills, Lake San Marcos or anywhere in San Marcos? Book a 30-minute call with Brian McArthur. We will look at your doctors, your income picture and whether a Supplement or an Advantage plan fits.
Book your call at go.designmymedicare.com/brian
Phone: 619-885-0556
For the full comparison, see Medicare Advantage vs. Medicare Supplement. Nearby areas we serve: Escondido, Vista, Carlsbad and Rancho Bernardo. If your Medicare Advantage plan is ending, see what to do if you are losing your Medicare Advantage plan in 2027.
Brian McArthur is a licensed insurance agent. Design My Medicare® and the Medicare Execution Process® are registered trademarks. Premium figures cited are 2026 standard amounts published by CMS; individual premiums vary based on income (IRMAA), plan choice and carrier. Not connected with or endorsed by the U.S. government or the federal Medicare program.
