If you're among the 63 million Americans enrolled in Medicare, you probably know about some attractive benefits of Medicare Advantage Plans. The Medicare Advantage Plan, also known as Medicare Part C, allows you to receive your Medicare benefits in an alternative and improved way. These plans are provided by Medicare-approved private insurance companies that offer the same level of coverage with added benefits.
Switching from the Original Medicare to Medicare Advantage can be easy, but deciding to switch can be daunting—you may not understand the better choice. Although Medicare Advantage plans have some attractive features for many people, other characteristics may not fit your personal preferences. You'll need to analyze attractive and unattractive characteristics to determine whether they fit your health needs.
Read on to learn about the pros and cons of switching to the Medicare Advantage Plan.
How Medicare Advantage Plans Work
Medicare Part C offers similar health coverage as Original Medicare Part A and Part B under the same policy. Medicare Advantage plans can also include benefits such as dental, hearing, vision, and prescription drugs (Part D).
The Medicare Advantage plans providers enter into a contract with Medicare, where the government pays a pre-agreed fixed amount for each plan. In turn, the private insurers cover a portion of your medical costs according to Medicare guidelines. However, this coverage comes at an added cost, as many plans require a copayment for deductibles and premiums. Nonetheless, the amount of deductibles depends on your care and coverage preferences. Despite the Medicare Advantage plan you choose, you must pay your Original Medicare monthly premiums.
Various Medicare Advantage plans have different rules. For example, while some plans may need referrals to see a specialist, others may restrict you to a particular network of healthcare providers in the plan's network. In addition, every Medicare Advantage plan has an optimum out-of-pocket amount. If you spend the maximum amount before the year ends, your Medicare Advantage will cover all costs for your covered Medicare services.
Pros of Switching to Medicare Advantage Plan
As you advance in age, it's natural for your immune system not to respond effectively to health issues. You may require comprehensive health coverage to cover your increasing health needs. Here are the advantages of switching to Medicare Advantage plans.
Coordinate Care Among your Health Care providers
Generally, Medicare Advantage plans have networks of contracted healthcare providers. The insurance providers select a network of physicians who suit your health needs. For instance, the Health Maintenance Organization (HMO) plan may require enrollees to select a Primary Care Physician (PCP) who can coordinate their care. In addition, plans that include Medicare prescription drug coverage may be linked to medication therapy. This coordination allows you to access convenient and reliable care when needed.
Acts as Your One-Stop Care Center
Most Medicare Advantage plans bring Medicare Part A, Part B, and Part D into one package—Part C. This means you can get all these benefits using a single insurance card. You don't have to keep many documents to receive a comprehensive care package. In addition, Medicare Advantage plans have other benefits—hearing, vision, and dental care—not included in Original Medicare.
Medicare Advantage Plans Can Cost Less
When you enroll for a Medicare Advantage plan, you'll continue to pay your Original Medicare premiums and additional premiums in the new plan. Your insurer will determine the Medicare Advantage plan's premiums based on your coverage needs. The cost of added premiums varies among private insurance providers.
However, your copayment may be less under your Medicare Advantage plan. For instance, if you visit a PCP under Medicare Advantage, you can have a copayment of around $10. But, if you visit a PCP under your Original Medicare, it may cost you a coinsurance of $20. In addition, paying a stand-alone Medicare Part D in Original Medicare makes a Medicare Advantage plan cheaper for more services.
Medicare Advantage plans have a maximum out-of-pocket limit. Once you pay your maximum premiums, you don't have to pay an extra penny even if you continue receiving healthcare services. Original Medicare doesn't have an optimum out-of-pocket cap, so you may have to pay a lot on healthcare services.
Some Medicare Advantage plans may include the zero-premium plan. A Zero-premium Medicare Advantage plan is free of monthly premiums. This implies that you don't pay the insurance company for your monthly health coverage—you can access Medicare services for free. But, it's important to note that you'll have to pay your Part B premium despite the zero-premium coverage. The zero-premium Medicare Advantage plan allows you to access other coverage benefits without additional payment from the current Original Medicare premiums.
Disadvantages of Medicare Advantage Plan
Although Medicare Advantage plans have various benefits, there are also undesirable features.
Complex Networks Limits Your Choice of Providers
Most Medicare Advantage plan providers have networks such as HMOs and preferred provider organizations (PPOs). These networks can limit you from receiving the health receives you want. For instance, the healthcare provider network limits you to a network of physicians who can provide care services. You may not get health services from your preferred physicians if they aren't enrolled in the Medicare Advantage plan network. In addition, some HMOs would require you to get referrals to access a specialist physician.
No Medicare Supplement
Medicare Supplement plans are essential when you have Medicare's out-of-stock expenses. It can cover extra copayments and deductibles. But, Medicare Advantage plans don't work with Medicare Supplements. This implies that it is impossible to weigh the cost of your Medicare Advantage plan with Medicare Supplement.
Specific Service Areas
Most Medicare Advantage plans have service jurisdiction limits. You may not access particular health care coverage if the services are unavailable in your region. To enroll for a new service, you must have resided in the area where the service is offered for at least six months. If you have to switch between residences across states, it may be difficult to meet the Medicare Advantage plan requirements.
Get a Medicare Plan that Suits Your Health Needs
If you're an automobile insurance buyer or automobile owner, you never know when a tragedy can occur while on the road. Insurance coverage that suits health needs that may arise from accidents or other health issues is always the best way to ensure healthy living. You can save money by practicing due diligence.
If you're unsure whether to switch to Medicare Advantage plans, it's always best to analyze your health needs and the different Medicare Advantage plans offered in your jurisdiction. Ifficient Inc. can help you find the best plan to insure your health. We provide high quality opt-in leads on pay for performance basis to help you determine your best insurance cover.
Contact us to help you make the best health coverage decision.