What is cost effective depends on how you have to use it.
If you have no medical needs, the most cost effective plan is no supplement at all. That way you waste no money on premiums.
The most comprehensive supplement is a Plan F, but it also has the highest premiums, and if it pays nothing to you, this is not cost effective.
Several Part B supplements in between "nothing" and F, not all companies offer all of them, premiums for supplements are the same statewide for each state, doesn't matter whether you are in Houston or Kermit.
If you are asking about HMOs or Medicare Advantage, that's something else. Those are alternatives to Part B or Parts B and D, and many are zero premium, but each are different as to what they will do for you. You have to shop those based on your needs, and if an RVer, one of those needs might be travel.
I chose a Plan N from AARP/UHC because it is national coverage and my retirement plan pays part of the premium if I buy a supplement from that company (but not anything for HMO or Advantage, nothing toward Part D). In the five years I've been on the plan, I've paid more in premiums than I received in benefits. Most years nothing. For Part D, never.
That's not cost effective effective, but I've also paid about $15,000 to $20,000 in car insurance premiums since last making a claim, at least $50,000 in homeowners without ever making a claim, and who knows what on life insurance and I'm still alive. Whatever I paid for life on my wife, it all expired on basis of age four months before she died.
My idea of the way to shop for insurance is to figure out how much of the risk I can afford to carry myself, and try to insure the rest. Premiums are based on risk to the insurer, the more they take care of, the more the policy costs. What I can carry on medical costs, and where I want coverage (i.e. includes outside the U.S.) means I use Supplement N, not Supplement F. What I can carry on automotive and home losses means I have deductibles at $1000 to $5000 on the vehicles, 10% on the homes, so as to reduce my premiums.
What works for me may not work for you. If you want no out of pocket costs, you will pay the highest premiums, whether or not you ever make claims, or in this case, need medical services.
For Medicare Part B Supplemental insurance, the plans are all defined by the Federal Government. You pick the plan that fits your need to balance risks with premium costs. You find one of the carriers that offers it. If you plan to travel, you want to pick a carrier with nationwide provider networks and a reputation for good service, not one that offers the plan only for Houston for $5-10 a month less.
If you don't understand how this works, you need to get a current "Medicare & You" and study it, because when you first come into the program there will be hundreds of salespeople out there, each with his own pig in a poke. Each of them telling you that you could be paying less, or pay nothing at all (actually, they take the money that would give you Medicare coverage and you are covered by them and not by Medicare). Once you choose something it dwindles down to about three phone calls a day and five mailings a week, looking for your Medicare or Medicare Supplement dollar.
Tom Test
Itasca Spirit 29B
