An estimated 96 percent of people 65 years of age and over have Medicare coverage. Considering that there are four parts of Medicare, each covering different things, securing the right health insurance plan can seem complicated. Medicare Advantage plans can meet all your health and prescription drug coverage needs, helping to protect you from huge bills. But what exactly is a Medicare Advantage plan and how does it work?
Here’s what to know.
WHAT IS A MEDICARE ADVANTAGE PLAN?
Medicare Advantage, also known as Medicare Part C is a Medicare replacement plan. Advantage Plans are a type of health insurance plan offered by private companies approved and regulated by Medicare. This means that the entire package of benefits will come from a private insurance company.
Typically, Medicare Advantage plans give all the Part A and Part B benefits that Original Medicare provides, and oftentimes also include prescription drug coverage (Part D). This makes it an all-in-one alternative to Original Medicare. The private health plans set a limit to the amount you will pay out-of-pocket for the covered services every year, this year the max out of pocket is $7550.00 effectively protecting you from unexpected costs.
HOW IT WORKS
Before joining a Medicare Advantage plan, you should understand how it works. With this type of health insurance plan, you will pay a monthly premium to a private insurance company. These plans will usually have lower premiums, but the costs vary from plan to plan. The Medicare Advantage plan offers coverage for inpatient hospital (Medicare Part A) and outpatient (Medicare Part B) services. The health insurance plans often include drug coverage (Part D), and may offer additional coverage like dental, hearing, vision and fitness benefits.
MEDICARE ADVANTAGE vs. ORIGINAL MEDICARE AND A SUPPLEMENT
An alternative to choosing Medicare Advantage would be to go for Original Medicare plus supplemental insurance. Although both policies can help you cover gaps in Medicare, they are designed differently. Supplement plans are designed to cover most everything Medicare does not, like the deductibles and the 20% coinsurance. To make the right decision, you need to understand how Medicare Advantage compares to the latter.
Pros of Medicare Advantage
• Private insurers are likely to offer more options in terms of the different plans available.
• Often includes prescription drug coverage to help pay for prescription drugs and medications.
• The plan may offer extra benefits such as dental, hearing, vision and fitness. As such, you will not need to pay for the services out of pocket.
• The out-of-pocket maximum is designed to protect you from huge medical bills.
• Premiums for Medicare Advantage plans are generally low and some maybe no additional cost or $0
Cons of Medicare Advantage
• Most Medicare Advantage plans will restrict you to using specific physicians and other providers within their network. Visiting a healthcare provider outside the network could lead to higher costs.
• There are many Medicare Advantage plan options depending on your location. The complex plan offerings can feel overwhelming for some people.
So, should you choose a Medicare Advantage or Medigap plan? There is no right answer. Medicare Advantage plans are not right for everyone but in some cases they may be the best option. The decision on whether to enroll for a Medicare Advantage plan will depend on your specific situation. This may be a good option if you want to have all your healthcare coverage under one roof or would like to receive additional benefits.
Medicare Support Services group is a full-service organization that is committed to helping clients obtain the best coverage for the lowest price. We represent all the top insurance companies and have dedicated experts who will educate you on the choices available and help you choose the right health insurance plan for your needs. Feel free to contact us to learn more and get a plan that is perfectly suited for your specific requirements.