Before you can make ANY decisions about Medicare you have to know and understand these important truths about Medicare Advantage.
Medicare Advantage is network based.
Perhaps the most important thing you need to understand about Medicare Advantage programs is that they all rely on some type of network of providers. These networks come in the form of either an HMO, PPO, or PFFS. There can be some variances of these, but these are the most common. I will break down these networks in part 3 of this series.
Advantage plans are not created equal.
Although they are structured the same; Medicare Advantage plans can vary drastically from plan to plan. This means that you must do your homework before joining one of these Medicare Supplement Plan G. You should start by identifying whether or not your providers are in network. The second biggest factor to consider which most people ignore is the Maximum Out-of-Pocket. Don’t get caught up in comparing little things like doctor’s copays unless the doctor’s office is your second home!
MA plans provides a Maximum Out-of-Pocket.
Continuing on from the previous point, the Maximum Out-of-Pocket is one of the biggest benefits of Medicare Advantage. If you remember on my previous article about Original Medicare; it does not give you this protection. For people that can not afford a Medicare supplement or just want to save some money, the Maximum Out-of-Pocket feature of Medicare Advantage plans offers great security.
Medicare Advantage is still a part of Medicare.
I’m including this truth because I have found that many people believe that they lose their Medicare benefits when they join an Advantage plan. The truth is that Medicare Advantage is actually called Part C of Medicare. Yes, it does override your Part A and Part B benefits, but this is actually a good thing for you because it allows you to in many cases not to have to pay large deductibles and that 20%.
Medicare Advantage is not right for everyone!
I can’t tell you that one plan fits all. Unfortunately, since every plan is different, and your needs are different than your neighbors; I can’t tell you to go join one particular plan. But I can tell you that some of the most popular plans are offered by Humana, United Healthcare, Wellcare, and Healthspring. Start by asking yourself these questions; How important is freedom of choice when it comes to your health providers? How important is cost? How healthy am I? Once you answer those questions you can easily decide whether you want to be in an Advantage plan or in Original Medicare with a Medicare Supplement.
As a senior you probably know, there are alternatives to Original Medicare to choose from and one of those are medicare advantage plans. Nowadays, most seniors prefer to go with an advantage plan over Medicare since they’d have more coverage and additional benefits, plus out of pocket expenses are going to be lower. In spite of this, you are going to have a difficult time on deciding which insurer or what level of coverage to go with if haven’t done your research. Regardless of whether you are concerned about your medical costs of the future or just the ones you are going through now, learning about advantage plans to replace your Medicare will be a terrific idea.
Who Sponsors Medicare Advantage Plans?
You have got to understand that all insurers in the United States are structured around making money. As a result, they are only agreeing to take on the risk of a seniors medical bills because they think that they can make a profit, they are accepting that sort of risk on the basis that they will make much more money then that have got to spend. Ordinarily, the federal government assists in funding the advantage plan, through the premium that are paid by the medicare recipient, as well as the premium that is paid directly to the company. In these situations, the insurance company will most probably end up generating revenue simply because they’re able to designate deductibles and excess charges to its consumers and also have access to specialists to invest those funds.
Medicare Advantage Plans- Cost
You have probably realized by now that Medicare plus a supplemental plan costs a great deal more then any medicare plan on the market. For instance, there are a ton of Medicare advantage plans that are literally absolutely free for all seniors have have already enrolled into Medicare Part B. Generally, that premium for Part B is going to have to be paid by you. Those co-pays and deductibles will still be there depending on how comprehensive your medicare plan is. Depending on what sort of added benefit the plan includes, you may have to pay an additional premium. Additional benefits can include the following:
- Dental coverage
- Vision care
- Prescription drug coverage (only in certain plans)
