What Are Medicare Advantage Plans? Here’s What You NEED To Know First
Medicare Advantage plans aren’t necessarily a great fit for everyone, they are better suited to some individuals and families than others.
Before you can determine whether this is a great fit for you, it helps to be able to answer what they are in the first place. From Original Medicare, to added prescription drug coverage, Medicare Advantage could be a great fit for you as a Medicare supplement.
Let’s take an in-depth look at what advantage plans are, who they are geared towards, what services and coverage they offer, and who can benefit the most from having a Medicare Advantage plan.
You have questions, and we have answers. By the time you’re finished reading this page, all of your questions should be answered, or at the very least, you’ll know where to go to find the answers you need.
Medicare advantage is also known as: MA, or Medicare Part C.
7 Fast Facts About Medicare Advantage Plans
- Part C is a combination of Part A and Part B, offered by a private insurance company that has a contract with Medicare. Instead of Medicare (in this case, referred to as “Original Medicare”) funding the plan, it’s a private company who has to follow certain guidelines set by Medicare but can also create some of their own rules and coverage options.
- MA (Part C) can also include additional coverage and benefits that aren’t included in Part A or Part B, which is what makes this type of plan appealing to most people. The extra benefits on top of Part A and Part B, for an additional cost, are a worthwhile investment for some, but not for other people.
- There are limits on what Part C plans are allowed to charge, and they cannot charge more for things that are included in Original Medicare (A and B).
- The additional benefits from Part C can include prescription drugs (if you don’t have a separate PDP), and things like dental care, vision care, and hearing.
- These plans offer a convenient way to take care of all of your health insurance coverage needs under one umbrella, so everything is bundled together into one policy – it saves you from having to keep track of multiple different plans from different providers, which can get stressful.
- You’re able to choose which additional benefits you want. If you rarely need dental work and decide it’s cheaper to pay for that on your own, or if you don’t need vision, or whatever else – you can find a plan that suits your needs.
- MA plans have a cap on the amount you may have to pay out-of-pocket in any given year. You may end up paying a bit more in premiums, but if you require additional care beyond this cap, your Part C plan will cover it for you, rather than Original Medicare which could have you paying more in out-of-pocket costs.
How Much Does a Medicare Advantage Plan Cost?
MA’s have out-of-pocket costs for the policy holder (you), but they aren’t written in stone. These costs are influenced by a handful of different factors. Here are some different factors in how much Medicare Part C will cost you:
- What your deductible is: If you have a yearly deductible on your plan, or any other deductibles, those will contribute to a higher cost overall.
- What your premiums are: If you have to pay a monthly premium, that is one cost that you can accurately estimate once you know what the premium payment is. Not every plan charges a monthly premium, however.
- How much you use it: If your MA covers a portion of each doctor’s visit, you’ll end up paying more in total if you visit your doctor more often.
- How much your copayment is: If you have a copayment for different services, this will also impact how much you spend in total. A lower copayment with more doctor’s visits could end up costing you less than if you had fewer visits with a higher copayment.
- The types of services you need: Your medical and healthcare needs will have an impact on the amount of money you end up spending.
- If you follow the plan’s rules: Your plan will have rules and guidelines like sticking to their network providers, and breaking these rules will result in additional costs to you.
- Additional benefits you qualify for: Some states will offer additional support in certain circumstances.
You need to shop around and look at what each plan offers in order to truly know what you’ll end up paying, we simply can’t give an accurate exact quote without additional information.
If you give us a call, we can help you navigate your options and to find a plan that fits you just right. We’ll take the time to explain the differences, and what you can expect to pay in different scenarios. It’s never fun to get a surprise medical expense that you weren’t expecting, especially when you’re paying for Medicare and trying to do everything correctly.
It’s common for people to wonder “Is Medicare Advantage a good deal?” If it’s not a good deal for you – what’s the point? Whether or not it will save you money depends on what type of prescription drug coverage you need or whether you even need a prescription drug plan at all. Part C can be a great value for some, and not a great deal for others, which is kind of the nature of insurance. It’s all about weighing the benefits, the cost of coverage, and the risk of not having more complete cover should you need it.
For example, you could end up needing an expensive prescription drug down the road. Before you can determine whether or not a Medicare Advantage plan is a great deal for you, you’ll need to know exactly what each private insurance company in your state is offering in terms of said Medicare Advantage plan.
If you’re in New York, or the District of Columbia, or California, or anywhere else your options can vary quite a bit. Make sure you understand what your plan does and doesn’t cover!
What are the Advantages and Disadvantages of Medicare Advantage Plans?
Healthcare in America can change on a dime, you never know when a new leader will take charge and adjust things to suit their vision.
When it comes to drug coverage, you won’t get this from Original Medicare in Part A or Part B, which is why Part C can be very helpful in certain cases. Aside from Part C, you could also get your drug coverage as a stand-alone option from an insurance company, but that’s not always your best option.
The key advantages are having all of your health insurance handled in one place, which can be much more convenient. The cap on out-of-pocket expenses can also be helpful with budgeting.
A disadvantage, in some cases, is you end up paying extra when it comes to premiums, copays, or deductibles. These are all things we can help you determine before you choose a private producer for MA.
Where To Find a List of Medicare Advantage Plans
Seeing a big list of advantage plans isn’t necessarily helpful if you don’t have the context to fully understand the nuances of the differences between them, but the general purpose of looking at a big list of plans is to help yourself find the best option for you. Instead of going in blind, why not reach out to us, and we can help you choose the best plan that’s available to you and suits your needs?
Here’s the list from Medicare.gov, but it can be very overwhelming. If you would like some help with this, just reach out to us and we’ll help guide you through the process from start to finish, until you end up with a perfect plan to suit your healthcare needs and your budget.
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