What is Medicare Advantage?

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Medicare Advantage is an alternative to Original Medicare that private insurers offer. This contract with the federal government allows them to provide healthcare benefits for people who qualify and have enrolled in one of these plans.

Choosing the right Medicare plan at the correct time is an extremely important decision, so it’s best to let us help with a FREE Medicare consultation to educate you on all your options.

Medicare Advantage Plans

Medicare Advantage plans must cover the same services offered under Original Medicare, but they may also additional services that are not typically covered. Each plan has different benefits. Many of these extra benefits might appear like they’re a good value, but often good marketing makes them seem that way. So it is important to weigh your options before signing up.

A person who enrolled in a medicare advantage plan would not have access or pricing flexibility like regular dual-eligible (both part D & healthcare reform) individuals do; however, there are many positives about this type of coverage including increased drug protections for those with high costs

Medicare Advantage plans offer the same benefits as Original Medicare, but they might also cover additional services like eyeglasses and hearing aids. Many of these healthcare insurance packages include prescription drug coverage as well.

Medicare Advantage Cost

Medicare Advantage plans might offer more generous benefits than traditional Medicare, and many plans have a monthly premium you’re required to pay which helps pay for those extras.

IMPORTANT!

People who enroll in an MA plan still have to pay their monthly Part B premium which typically gets deducted from one’s social security check each month. Some people may get help from Medicaid or a Medicare savings program as well, however, most people will need to pay this Part B premium ($170 in 2022).

Coverage and Networks

Medicare is a great way to get affordable health care. That’s why original Medicare and Medigap continue with their coverage, which means that you can go see any doctor or hospital without worrying about getting turned down for your requested treatments because they’re not in-network providers under this program.

But what happens when someone joins an Advantage plan instead? Well unfortunately there are some downsides–if one chooses provider networks too carefully then he/she might find themselves stuck paying more throughout the year since many require members to stay within them at all times except for emergency services.

If you choose to enroll in an Advantage plan, it must be a plan that is offered in your area. Then you must check to see if all of your doctors participate in the plan and network. It can be quite a bit of work, that’s what we encourage you to allow us to help. It’s FREE!

How to Enroll in an Advantage Plan

Medicare offers a few different opportunities to enroll in a private Medicare Advantage plan during the year. The first is an Initial Enrollment Period, which can also be used by new beneficiaries when they join Medicare for the very first time. This is called the Initial Enrollment Period.

Outside of this period, you may enroll or disenroll from an Advantage plan during the Annual Election Period, or open enrollment period each year. This runs October 15th – December 7th, then changes go into effect the following January 1st.

Medicare Advantage Plan PROS and CONS

While all those TV commercials claiming massive benefits each year might seem attractive, in reality very few people realize exactly what they’re enrolling in when they choose an Advantage plan, and there can and often are major downsides. The old joke in this industry is “Medicare Advantage plans are great if you never have to use them!”

That being said, if you’re healthy and don’t use your coverage very often, an Advantage plan might be a good option for you. Below are some pros and cons when considering a Medicare Advantage plan.

PROS:

  • Relatively low or even $0 monthly premiums
  • Plans may include additional benefits such as prescription, dental vision and hearing, and sometimes gym membership coverage
  • Plans have out-of-pocket limits that you can be billed up to each year

CONS:

  • You’ll have a network you need to remain in; Doctors can leave the network at the end of each year
  • Advantage plans can require prior authorization for procedures, and decline your coverage
  • Plans can have up to a maximum $7,550 out-of-pocket limit. This means you can be billed each year up to this amount

How do you choose a plan?

As you can see, there is a lot to consider when choosing the right Medicare plan. We make it easy for you by helping you understand all of your options. And our service is entirely FREE.

Call today to speak to one of our experienced agents who can answer all your questions for you.

1-888-891-0229

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