Medicare Blog

why should i buy a medicare advantage plan

by Dr. Elias Green DDS Published 2 years ago Updated 1 year ago
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Here are some reasons to favor Medicare Advantage plans:

  • Many Medicare Advantage plans, unlike original Medicare, cover hearing, vision and/or dental care. Medicare Advantage...
  • A Medicare Advantage plancan cost you less. Original Medicare will often have you footing 20% of many bills with no...
  • While original Medicare can't be used outside U.S. borders, some Medicare...

Full Answer

Is Medicare better than Advantage plans?

A Medicare Advantage (MA) plan is a type of health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Parts A and B benefits. MA plans include health maintenance organizations, preferred provider organizations, private fee-for-service plans, and Special Needs Plans.

When to choose Original Medicare vs. Medicare Advantage?

Apr 16, 2021 · Summary: Medicare Advantage plans can be full of extra benefits like prescription drug coverage, dental, hearing, and vision coverage. Another advantage of a Medicare Advantage plan is a mandatory out-of-pocket maximum. A possible disadvantage of a Medicare Advantage plan is you can’t have a Medicare Supplement plan with it.

What are the most popular Medicare Advantage plans?

Jan 16, 2017 · Here are some reasons to favor Medicare Advantage plans: Many Medicare Advantage plans, unlike original Medicare, cover hearing, vision and/or dental care. Medicare Advantage... A Medicare Advantage plancan cost you less. Original Medicare will often have you footing 20% of many bills with no... ...

How does Medicare Advantage compare to Medicare?

May 12, 2020 · Medicare Advantage is private healthcare offered by companies like BlueCross BlueShield, UnitedHealthcare, and AARP (just to name a few). MA plans are able to offer extra benefits and even $0 premium plans because the federal government subsidizes it. Shifting the Risk from CMS to Private Insurance Companies

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How Do Medicare Advantage Plans Work?

Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. Every month, Medicare pays the private insurance...

What Are The Downsides of Medicare Advantage Plans?

Since Medicare Advantage plan coverage is administered through a private insurance company, the rules and guidelines can vary, which can lead to re...

What Are The Pros of Medicare Advantage Plans?

1. Some insurance companies could offer a $0 premium for the Medicare Advantage plan. Medicare Advantage plan availability will depend on the count...

How Do I Choose A Medicare Advantage Plan?

It’s up to you to determine which type of coverage is the right option. It’s important to read all of the details of each Medicare Advantage plan,...

Do I Qualify For Enrollment in A Medicare Advantage Plan?

Qualifying for enrollment in a Medicare Advantage plan requires that you are enrolled in both Medicare Part A and Part B. People with end-stage ren...

What are the benefits of a syringe?

Other extra benefits may include: 1 Meal delivery for beneficiaries with chronic illnesses 2 Transportation for non-medical needs like grocery shopping 3 Carpet shampooing to reduce asthma attacks 4 Transport to a doctor appointment or to see a nutritionist 5 Alternative medicine such as acupuncture

What are the disadvantages of Medicare Advantage?

A possible disadvantage of a Medicare Advantage plan is you can’t have a Medicare Supplement plan with it. You may be limited to provider networks. Find affordable Medicare plans in your area. Find Plans. Find Medicare plans in your area. Find Plans.

Is Medicare Advantage regulated by Medicare?

If you’re new to Medicare, you may be curious about Medicare Advantage. Here are some pros and cons of enrolling in a Medicare Advantage plan. For starters, Medicare Advantage plans are offered by private insurance companies but are regulated by Medicare. Regardless if the Medicare Advantage plan you choose has a monthly premium or not, ...

Is Medicare Advantage regulated by private insurance companies?

Here are some pros and cons of enrolling in a Medicare Advantage plan. For starters, Medicare Advantage plans are offered by private insurance companies but are regulated by Medicare.

Is Medicare Advantage a private insurance?

For starters, Medicare Advantage plans are offered by private insurance companies but are regulated by Medicare. Regardless if the Medicare Advantage plan you choose has a monthly premium or not, you must continue to pay your Medicare Part B premium.

Does Medicare Advantage have a monthly premium?

For starters, Medicare Advantage plans are offered by private insurance companies but are regulated by Medicare. Regardless if the Medicare Advantage plan you choose has a monthly premium or not, you must continue to pay your Medicare Part B premium. Some Medicare Advantage plans have premiums as low as $0.

Does Medicare have an out-of-pocket maximum?

You may not know that Original Medicare (Part A and Part B) has no out-of- pocket maximum. That means that if you face a catastrophic health concern, you may be responsible to pay tens of thousands of dollars out of pocket.

Does Medicare Advantage give you more coverage?

Medicare Advantage plans can give you more coverage and can cost you less. Learn more about their benefits and drawbacks to see if you want to enroll in one. Selena Maranjian. (TMFSelena)

Who is Selena Maranjian?

Author Bio. Selena Maranjian has been writing for the Fool since 1996 and covers basic investing and personal finance topics. She also prepares the Fool's syndicated newspaper column and has written or co-written a number of Fool books.

What is Medicare Advantage?

Medicare Advantage in a nutshell. When you enroll in Medicare -- which you can do at age 65 -- you can choose either the "original" Medicare package of Part A and Part B (covering, respectively , hospital and medical expenses) or a Medicare Advantage plan, sometimes referred to as Part C. Those who opt for original Medicare typically augment it ...

Does Medicare Advantage cover dental?

Many Medicare Advantage plans, unlike original Medicare, cover hearing, vision and/or dental care. Medicare Advantage plans also typically include prescription drug coverage, while those with original Medicare have to sign up for -- and pay for -- Part D coverage. A Medicare Advantage plancan cost you less. Original Medicare will often have you ...

Does Medicare Advantage include prescriptions?

Medicare Advantage plans also typically include prescription drug coverage, while those with original Medicare have to sign up for -- and pay for -- Part D coverage. A Medicare Advantage plancan cost you less.

How do Medicare Advantage plans earn their stars?

Medicare Advantage plans earn their stars by being evaluatedon measures such as how well they're keeping their members healthy (via screenings, checkups, and more), how well they're managing members' chronic conditions, and how good their customer service is.

Does Medicare Advantage cost less than original Medicare?

A Medicare Advantage plan won't necessarily cost you less than original Medicare would . You need to take a close look at any plan you're considering and compare it with original Medicare, keeping your health profile and likely healthcare needs in mind.

Is Medicare Advantage private or public?

Medicare Advantage Is Private Healthcare. Original Medicare is healthcare provided by our federal government. Medicare Advantage is private healthcare offered by companies like BlueCross BlueShield, UnitedHealthcare, and AARP (just to name a few). MA plans are able to offer extra benefits and even $0 premium plans because ...

What is Medicare Advantage?

Medicare Advantage is private healthcare offered by companies like BlueCross BlueShield, UnitedHealthcare, and AARP (just to name a few). MA plans are able to offer extra benefits and even $0 premium plans because the federal government subsidizes it.

Does Medicare cover over 65?

Original Medicare has figured out that healthcare for a person over 65 costs them a certain dollar amount. They figure if they pay a private insurance company a little less, they’re saving money.

Does Medicare pay a monthly premium?

They figure if they pay a private insurance company a little less, they’re saving money. Michael Rainey, a commentator for The Fiscal Times, explains the private insurers are responsible for managing their plans to ensure a profit. So, Medicare pays a monthly premium to that private insurance company on your behalf.

Can you enroll in Medicare Advantage instead of Original?

That private insurance company then offers Medicare Advantage plans you can enroll in instead of Original Medicare. CMS, the Centers for Medicare & Medicaid Services, believes they are saving money by getting you off of Original Medicare and moving you over to a Medicare Advantage plan. That helps explain why CMS has been accused ...

Is Medicare Advantage managed care?

Medicare Advantage Is Managed Care. We know that CMS pays private insurance companies a monthly fee for each individual they insure. That’s how these private companies can offer extra benefits and even $0 premium in many cases. However, another way MA plans can offer more benefits for $0 premium is because it’s managed care.

How much does Medicare cost in MA?

Many MA plans have $0 premium, while Medicare Supplements routinely cost $100-$125 per month in premium. The Plan Finder tool is hyper-focused on premium, and there are a lot of non-monetary components that the Plan Finder fails to highlight.

What to know about Medicare Advantage?

Things to know about Medicare Advantage Plans. You're still in the Medicare Program. You still have Medicare rights and protections. You still get complete Part A and Part B coverage through the plan. Some plans offer extra benefits that Original Medicare doesn ’t cover – like vision, hearing, or dental. Your out-of-pocket costs may be lower in ...

Is Medicare still in the program?

You're still in the Medicare Program. You still have Medicare rights and protections. You still get complete Part A and Part B coverage through the plan. Some plans offer extra benefits that Original Medicare doesn’t cover – like vision, hearing, or dental.

Does Medicare cover vision?

You still get complete Part A and Part B coverage through the plan. Some plans offer extra benefits that Original Medicare doesn’t cover – like vision, hearing, or dental. Your out-of-pocket costs may be lower in a Medicare Advantage Plan.

Can you pay more for a Medicare Advantage plan than Original Medicare?

Medicare Advantage Plans can't charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care. Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services.

Does Medicare have a yearly limit?

Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.

Can you check with a health insurance plan before you get a service?

You can check with the plan before you get a service to find out if it's covered and what your costs may be. Following plan rules, like getting a Referral to see a specialist in the plan's Network can keep your costs lower. Check with the plan.

Does Medicare automatically apply to Social Security?

It doesn't happen automatically. However, if you already get Social Security benefits, you'll get Medicare Part A and Part B automatically when you first become eligible (you don't need to sign up). 4. There are two main ways to get Medicare coverage: Original Medicare. A Medicare Advantage Plan.

What is Medicare Supplement?

Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). To help pay for things that aren't covered by Medicare, you can opt to buy supplemental insurance known as Medigap (or Medicare Supplement Insurance). These policies are offered by private insurers and cover things that Medicare doesn't, such as copayments, deductibles, and healthcare when you travel abroad.

Can you sell a Medigap plan to a new beneficiary?

But as of Jan. 2, 2020, the two plans that cover deductibles—plans C and F— cannot be sold to new Medigap beneficiaries.

What is Medicare Advantage Plan?

A Medicare Advantage Plan is intended to be an all-in-one alternative to Original Medicare. These plans are offered by private insurance companies that contract with Medicare to provide Part A and Part B benefits, and sometimes Part D (prescriptions). Most plans cover benefits that Original Medicare doesn't offer, such as vision, hearing, ...

Does Medicare cover dental?

Most plans cover benefits that Original Medicare doesn't offer, such as vision, hearing, and dental. You have to sign up for Medicare Part A and Part B before you can enroll in Medicare ...

Does the Cares Act expand Medicare?

It expands Medicare's ability to cover treatment and services for those affected by COVID-19. The CARES Act also: Increases flexibility for Medicare to cover telehealth services. Authorizes Medicare certification for home health services by physician assistants, nurse practitioners, and certified nurse specialists.

What age do you qualify for Medicare?

Image source: Flickr user pictures of money. If you've paid into Social Security for 10 years, you qualify for Medicare Part A and Part B at age 65. The healthcare insurance coverage offered via Part A and Part B provides seniors with a safety net against costly illness or injury, but there are some gaps in Medicare coverage ...

Is Medicare Advantage a private insurance?

Unlike Part A and Part B Medicare, Medicare Advantage plans are offered by private insurance companies such as Humana ( NYSE:HUM). Although the total coverage offered by these plans can differ from insurer to insurer, all Medicare Advantage plans must provide, at a minimum, comparable coverage to what is offered by the government-run Part A ...

Does Medicare Advantage cover hospitalization?

That means that Medicare Advantage plans will cover hospitalization, which is covered by Part A Medicare, and expenses associated with doctors, lab services, X-rays, mental health services, and other healthcare services, which are covered by Part B. However, the costs associated with this coverage, such as deductibles and other out-of-pocket ...

How long does Medicare pay for inpatient care?

For example, traditional Medicare Part A pays 100% of approved inpatient costs for the first 60 days you're hospitalized, and after 60 days, you share some of the costs of inpatient care.

Does Medicare have an annual cap?

Image s ource: Humana. Because traditional Medicare Part A and Part B doesn't have an annual cap on the amount of money a senior will pay for healthcare in any given year, many people prefer the out-of-pocket maximum that is offered by Medicare Advantage plans.

Why does Medicare Part A and Part B fall short?

Medicare Part A and Part B also fall short because they don't provide coverage for prescription medicine. In order to obtain insurance coverage for medicine, seniors need to either sign up for a separate drug plan, known as Part D, or enroll in a Medicare Advantage plan that offers drug coverage.

Does Part A pay for eyeglasses?

Part A only pays for vision loss that's associated with a medical emergency or traumatic injury requiring hospitalization and Part B doesn't pay for routine eye exams and only pays for eye glasses if they're required following cataract surgery.

Provider Considerations

Medicare Advantage plans have a network of providers. These provider networks have vastly improved recently, but they can still cause issues. HMOs are health maintenance organizations, and PPOs are preferred provider organizations. These are the two most common types of Part C plan networks.

Medigap Open Enrollment

Medigap is often referred to as the alternative to Medicare Advantage. When someone is more than six months away from their 65th birthday or their Part B effective date, they have to answer health questions to get a Medigap plan. When someone first turns 65 or enrolls in Part B, they can get a Medigap plan without answering health questions.

Skilled Nursing Care

Historically, there are very few issues with skilled nursing care when billing original Medicare. Most of the hysteria about Medicare Advantage online comes from people involved with the billing process of rehabilitation services, assisted living, skilled nursing, etc.

Is Medicare Advantage a good plan?

Medicare Advantage plans are not always as wonderful as they are made out to be. While the $0 premium may be enticing, the reality is that the out-of-pocket expenses and restrictions end up making them expensive over time. These plans are best for those who are relatively healthy.

Who is Devon from the Blue Jays?

Devon is a Canadian-based writer and a father of three young children. He's simultaneously trying to build college funds and plan for an eventual retirement. He's been in online publishing since 2013 and has a degree from the University of Guelph. In his free time, he loves fanatically following the Blue Jays and Toronto FC, camping with his family, and playing video games

What are the pros and cons of Medicare Advantage vs. Medigap plans?

Here are some pros and cons of each choice for additional Medicare coverage: Medigap that goes with original Medicare vs. Medicare Advantage, an alternative to it.

Why would you choose a Medicare Advantage over original Medicare coverage?

Medicare Advantage plans combine Medicare Part A (hospital insurance), Part B (medical insurance), and, usually, Part D (prescription drug coverage) in one plan, often for no more than the Part B premium. Many MA plans provide benefits like vision, hearing, and dental care that enrollees don’t get through traditional Medicare.

What are the biggest gaps in Medicare coverage?

Original Medicare doesn’t cover many services important to older adults, such as:

How do you know if you would benefit from a Medigap plan?

Medigap is a supplement to Medicare that helps you cover healthcare copayments, coinsurance, and deductibles from Medicare Part A and Part B. Unlike MA plans, new Medigap policies don’t provide prescription drug coverage.

The bottom line

Medicare Advantage plans bundle Medicare parts together and often offer extra benefits such as dental and hearing care, but they come with limited provider networks and may pose issues if you travel.

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