There are some medical coverage plans that go above and beyond what Medicare’s basic plan provides. The most well-known ones are the Medigap plans, which supplement the main plan, but Advantage plans offer so much more, even covering all original Medicare. The Medicare Advantage Plans are every bit as robust as in years past, and we are going to discuss those with you so that you can decide if one is right for you.
What Medicare Advantage Covers
The Advantage plan suffer so much more than most other medical coverage plans. They take care of everything you would get from the basic Medicare plan, save for hospice care. They also cover a lot of the more common expenses such as dental, wellness plans, vision and hearing. These apply to emergency room visits, doctor office visits and treatments. You won’t get this kind of coverage from a supplemental plan, even a high coverage one.
Many Advantage plans also take care of your prescription drug coverage, by including Part D coverage for you. You may still have to pay a little out for prescription drugs, but most of those costs will be covered.
There are times when the Advantage plan won’t cover you, particularly for procedures and treatments that are not considered medically necessary. The definition of that changes from time to time and from location to location. If you are not sure of a procedure is going to be covered and if it isn’t considered medically necessary, then you should ask your insurance agent and your doctor. You want to be sure that you know hat you are getting covered for, so that there are no unpleasant surprises when the medical bill comes. You can always ask before you receive any service if it will be covered under your plan.
You may not be able to go to certain doctors and get the same coverage if they are not on your plan’s network. The network varies from plan to plan and provider to provider, so be aware of which doctors and medical facilities are part of the plan’s network. If you go off network for treatment, you will often have to pay for it out of pocket. The only exception is usually when you have no other choice but to go to an off-network facility such as when you have a medical emergency and that facility is the closest one. In those cases, the Advantage plan carrier would be required to cover you.
The coverage you get from the Advantage plan is just as good as the original Medicare coverage or those same expenses. In fact, the Advantage plan is not allowed to charge you more for any expenses that would normally be covered by the standard Medicare plan. So, you don’t have to worry about paying more for expenses you can get covered by other plans.
Is It Right for You?
You should understand that Medicare Advantage Plans are not ideal for everyone. They offer tons of coverage, which is great for your peace of mind but not, perhaps, for your wallet. If you cannot afford an Advantage plan, then you should be looking at alternatives like Medigap plans or some other supplemental plan. The Advantage plans are not really considered supplement plans, since they cover all of Medicare and not just add on to it like the supplement plans do.
Of course, they cover a lot of the same medical expenses as the supplement plans, so you don’t need have both plans at once. If you already have a supplement plans when you decide you want an Advantage plan, then you should drop one to sign up for the other. Medicare won’t let you keep two plans that have overlapping coverage.
That’s true of the Medicare Part D prescription drug. If you have that Part D coverage already, and you want an Advantage plan that covers the same thing, then you need to drop the one to get the other. You cannot be signed up for two plans with overlapping coverage. If you don’t drop one on your own, then Medicare will cancel one of them for you, so make sure you plan your coverage before you sign up for a plan.
You should take some time to look at your coverage needs, your medical expenses and the state of your health and determine if Medicare Advantage plans would be right for you. Be sure to look at a few different Advantage plans, since they are not all the same. Each company tweaks their own Advantage plans here and there, and the rules for what will be covered and what won’t be changes slightly from one state to the next. It is worth your time to find out what your state considers medically necessary to know if you will be covered for procedures and treatments you may want to have done.
Advantage plans may offer too much coverage for your needs. If you examine the plans and find that they cost too much and cover things that you won’t ever need to pay for anyway, then you should look at some alternatives. The supplemental plans are good choices for people who only need a bit more coverage, and Advantage plans are only meant for people who have a lot of medical needs.
You can talk to both your doctor and your insurance agent to find out what kind of treatments and procedures might be coming up for you and what you may need to have covered. If you are planning for your future, then you can have a good idea if an Advantage plan is going to be too much or if it is an ideal plan for your situation.
Be sure to compare the different Advantage plans being offered and the prices between them. You might be surprised at how different they can be from one another. Some of the Medicare Advantage Plans won’t even cover prescription drug expenses, so be aware of what you are getting.