Medicare Blog

forbes what are the advantages of a medicare advantage plan

by Jay Schowalter Published 2 years ago Updated 1 year ago

Best Medicare Advantage Providers Ratings

Provider Forbes Health Ratings Coverage area Additional benefits CMS rating
Humana 5.0 Offers plans in all 50 states and Washin ... Dental, vision, hearing, lifestyle, ... 3.6
Blue Cross Blue Shield 5.0 Offers plans in 48 states Dental, vision, hearing, lifestyle, ... 3.8
Cigna 4.5 Offers plans in 26 states and Washington ... Dental, vision, hearing, lifestyle, holi ... 3.8
United Healthcare 4.0 Offers plans in all 50 states Dental, vision, hearing, lifestyle, ... 3.8
Jun 8 2022

What Are the Benefits of Medicare Advantage? Medicare Advantage plans provide all the same benefits provided by Original Medicare, plus coverage for items and services not covered by Original Medicare, including some vision, some dental, hearing and wellness programs like gym memberships.Jun 23, 2022

Full Answer

What are the pros and cons of Medicare Advantage plans?

Medicare Advantage Plans have pros and cons when compared to Original Medicare. Benefits include better coverage and the potential for lower premiums. Cons include less stability than Original Medicare and rules that govern coverage.

Why are Medicare Advantage plans bad?

  • $1,484 ($1,556 in 2022) deductible for each benefit period
  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $371 ($389 in 2022) coinsurance per day of each benefit period
  • Days 91 and beyond: $742 ($778 for 2022) coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)

More items...

How much does Medicare Advantage plan cost?

Medicare Advantage, also known as Medicare Part C, is simply an alternative way to get your Medicare Part A and Part B benefits. The main difference between the two is that Medicare Advantage plans are offered by private insurance companies, which means each company has some freedom to set its own premiums, cost sharing, and benefits.

What does Medicare Advantage plans mean?

What are the advantages of having a Medicare Advantage plan?

Medicare Advantage plans can serve as your “one-stop” center for all your health and prescription drug coverage needs. Most Medicare Advantage plans combine medical and Part D prescription drug coverage. Many also coordinate the delivery of added benefits, such as vision, dental, and hearing care.

What are the negatives of a Medicare Advantage plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

What is the benefit of having a Medicare Advantage plan versus traditional Medicare?

Most plansoffer extra benefits that Original Medicare doesn't cover--like some vision, hearing, dental, routine exams, and more. Plans can now cover more of these benefits. You can join a separate Medicare drug plan (Part D) to get drug coverage. Drug coverage (Part D) is included in most plans.

What is the most popular Medicare Advantage plan?

AARP/UnitedHealthcare is the most popular Medicare Advantage provider with many enrollees valuing its combination of good ratings, affordable premiums and add-on benefits. For many people, AARP/UnitedHealthcare Medicare Advantage plans fall into the sweet spot for having good benefits at an affordable price.

Can you switch back to Medicare from Medicare Advantage?

Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.

Why are Medicare Advantage plans being pushed so hard?

Advantage plans are heavily advertised because of how they are funded. These plans' premiums are low or nonexistent because Medicare pays the carrier whenever someone enrolls. It benefits insurance companies to encourage enrollment in Advantage plans because of the money they receive from Medicare.

What percent of seniors choose Medicare Advantage?

A team of economists who analyzed Medicare Advantage plan selections found that only about 10 percent of seniors chose the optimal Medicare Advantage plan. People were overspending by more than $1,000 per year on average, and more than 10 percent of people were overspending by more than $2,000 per year!

What are the advantages and disadvantages of Medicare Advantage plans?

Medicare Advantage offers many benefits to original Medicare, including convenient coverage, multiple plan options, and long-term savings. There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling.

Do you still pay Medicare Part B with an Advantage plan?

You continue to pay premiums for your Medicare Part B (medical insurance) benefits when you enroll in a Medicare Advantage plan (Medicare Part C). Medicare decides the Part B premium rate. The standard 2022 Part B premium is estimated to be $158.50, but it can be higher depending on your income.

What are the top 3 Medicare Advantage plans?

The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.

Who is the largest Medicare Advantage provider?

UnitedHealthcareUnitedHealthcare is the largest provider of Medicare Advantage plans and offers plans in nearly three-quarters of U.S. counties.

Does Medicare Advantage cover cataract surgery?

Medicare Advantage (MA) plans, as an alternative to Original Medicare, also cover cataract surgery. MA plans provide the same benefits as Original Medicare does, so if a service is covered under Original Medicare, in this case, cataract surgery, it is also covered under a MA plan.

What Is Medicare Advantage?

Medicare Advantage (also known as Part C) plans are provided by private insurers and essentially replace Original Medicare as your primary insurance. They cover all Medicare-covered benefits and may also provide additional benefits like some dental, hearing, vision and fitness coverage.

What Are the Benefits of Medicare Advantage?

Medicare Advantage plans provide all the same benefits provided by Original Medicare, plus coverage for items and services not covered by Original Medicare, including some vision, some dental, hearing and wellness programs like gym memberships.

How Much Does Medicare Advantage Cost?

Many Medicare Advantage plans have a $0 premium, so be sure to explore your options. Baethke explains it like this: “If you enroll in a plan that does charge a premium, you must pay this fee every month in addition to your Medicare Part B premium, which is around $149 [or higher, depending on your income].”

What Is Medicare Supplement?

Medicare Supplement plans (commonly known as Medigap plans) are sold by private insurance companies to help fill the gaps of Original Medicare coverage.

What Are the Benefits of a Medicare Supplement Plan?

A Medicare Supplement plan makes your out-of-pocket costs more predictable and easier to budget.

How Much Does a Medicare Supplement Plan Cost?

The estimated average monthly premium (the amount you pay monthly) for a Medicare Supplement plan can range from $150 to around $200, depending on the state you live in and your insurer.

Sources

NORC at the University of Chicago. Innovative Approaches to Addressing Social Determinants of Health for Medicare Advantage Beneficiaries. Better Medical Alliance. Accessed 9/6/21.

What Is Medicare Advantage?

Medicare Advantage is an all-in-one plan choice alternative for receiving Medicare benefits. You may also hear it referred to as Medicare Part C. This plan is bundled with Medicare Part A and Part B and usually includes Part D, which provides prescription drug coverage.

The Average Cost of a Medicare Advantage Plan

Some Medicare Advantage plans may have lower out-of-pocket costs than Original Medicare, and some have a $0 monthly premium. Here are a few questions to consider before purchasing a plan.

Types of Medicare Advantage Plans

There are four common types of Medicare Advantage plans to compare when making your selection.

Medicare Advantage vs. Original Medicare

Consider the following details when deciding whether a Medicare Advantage plan or Original Medicare is best for you.

Methodology

To determine the best Medicare Advantage providers of 2021, the Forbes Health editorial team evaluated all insurance companies that offer plans nationwide in terms of:

What is Medicare Advantage Plan?

Medicare Advantage plans, also called Part C of Medicare, are private plans that pay instead of Medicare. The Kaiser Family Foundation reported in 2016 that around 31% of Medicare beneficiaries opted for Medicare Advantage. Most Medicare Advantage plans today have either an HMO or PPO network. Members use that network for their healthcare.

Does Medicare Advantage have deductibles?

Deductibles. Medicare Advantage plans cover the same Part A and B services that are offered by Medicare. Some plans have deductibles for medical services or drugs before your benefits begin. Check the plan’s Summary of Benefits to see what expenses you’ll be responsible for upfront.

Is Medicare Advantage out of network?

Out-Of-Network Costs. Medicare Advantage HMO plans usually require you to use the plan’s network, except in emergencies. PPO plans are a bit more flexible and will allow out-of-network treatment. However, your share of those costs is often much higher than what you would pay in-network.

Do you pay more for Medicare Part B?

You won’t pay anything more than what you already pay for Part B. These plans can also include minor ancillary benefits, such as routine dental and vision care. While the lower premiums and extras are attractive, there are back-end costs in Medicare Advantage plans. These might be minimal while you are healthy.

Can Medicare Advantage plans change their benefits each year?

Medicare Advantage plans refile their benefits with Medicare each year. The benefits, drug formulary, pharmacy network, provider network, premiums, copays and coinsurance can change for the following year.

What is an Advantage Plan?

Advantage plans enable participants to receive multiple benefits from one plan, but all Advantage plans must also include the same coverage as Original Medicare (Parts A and B). When you have an Advantage plan and receive care, the insurance company pays instead of Medicare. Advantage plans are often HMOs or PPOs, ...

How much is Part B premium?

Still, those on Advantage plans must continue to pay their Part B premium. The standard Part B premium is $148.50. Those with lower incomes can get help paying this premium, while higher-income earners are subject to premium adjustment.

Can you see a doctor with Medicare?

With or without secondary Medigap insurance, Original Medicare coverage enables you to see any doctor accepting Medicare assignment. As of 2020, only 1% of physicians treating adults had formally opted out of Medicare assignment, so this is similar to having an unlimited "network."

Do you have to pay Medicare premiums for both Part A and Part B?

People who have paid Medicare taxes for 40 or more quarters receive Part A premium-free. You must enroll in both Part A and Part B to obtain an Advantage plan. So, while an Advantage plan stands in for your Medicare and might come without a monthly premium, you'll still be responsible for your Original Medicare costs.

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