9 Good Reasons Why a Medicare Advantage Plan Might Be Right for You
- Low or $0 Monthly Premium Payments. Medicare Advantages plans often have low-cost or even $0 premiums. Costs will...
- Financial Protection. Medicare Advantage plans provide a financial safety net due to a set annual out-of-pocket limit.
- Dental, Vision, Fitness and Hearing Coverage. Original...
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.
Does a Medicare Advantage plan replace original Medicare?
When enrolled in Medicare Advantage, you will receive your Part A and Part B benefits through your Medicare Advantage plan except for hospice care, which you will continue to receive through Part A. In this sense, Medicare Advantage does “replace” Original Medicare, because almost all of your Original Medicare benefits will be obtained through your Medicare Advantage plan.
How to choose the best Medicare Advantage plan?
The best Medicare Advantage plan is generally the one that includes your doctors in the plan’s network and your medications on the plan’s formulary. You can find Advantage plans from major carriers like United Healthcare, Aetna, Cigna, Anthem/Blue Cross Blue Shield, Humana, and quite a few other carriers.
Which is the best Medicare Advantage plan?
The best Medicare Advantage plan is generally the one that includes your doctors in the plan’s network and your medications on the plan’s formulary. You can find Advantage plans from major carriers like United Healthcare, Aetna, Cigna, Anthem/Blue Cross Blue Shield, Humana, and quite a few other carriers.
What is the point of a Medicare Advantage plan?
A Medigap policy is private insurance that helps supplement Original Medicare. This means it helps pay some of the health care costs that Original Medicare doesn't cover (like copayments, coinsurance, and deductibles).
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.
Do seniors like Medicare Advantage?
Nothing could be further from the truth. Seniors are flocking to Medicare Advantage because it provides better benefits at lower cost. Medicare Advantage plans are administered by private insurance companies that contract with the federal government.
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 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.
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 Medicare Advantage plans cover surgeries?
Medicare Advantage Coverage for Surgery Plans must include the same basic care as Original Medicare but often bundle other benefits — such as vision and dental — into a single plan. Medicare Advantage plans may require you to use hospitals and doctors within the plan's network for your surgery.
Does Medicare Advantage cost more than Medicare?
Medicare spending for Medicare Advantage enrollees was $321 higher per person in 2019 than if enrollees had instead been covered by traditional Medicare. The Medicare Advantage spending amount includes the cost of extra benefits, funded by rebates, not available to traditional Medicare beneficiaries.
Who is the largest Medicare Advantage provider?
United HealthcareUnited Healthcare Nearly three-quarters (74%) of UHC's HMOs have no monthly premiums. All offer vision and hearing benefits and 95% offer dental coverage. UHC is the nation's largest health insurer, with nearly 49.5 million members, including more than six million Medicare Advantage members.
Does Medicare Advantage have a prescription drug plan?
Aside from dental, vision, and hearing benefits, Medicare Advantage plans have built-in drug benefits. This feature means that a prescription drug plan, also called Medicare Part D, is often already part of the total package, at no additional cost to you.
Is Medicare Advantage getting better?
Lastly, Medicare Advantage plans are improving every year. The program progressively gets better and better as private insurers compete for your enrollment. Based on statistics, MA enrollments grew by 9 percent between 2019 and 2020 and are projected to continue to grow.
Does Medicare Advantage fit everyone?
Since Medicare Advantage plans may not fit everyone, you should talk with a licensed specialist if you are still unsure about MA plans. If you are confused and need more information, the team at CoverRight.com can easily help you. We are just a phone call away.
Why are Medicare Advantage plans so popular?
Medicare Advantage plans have gained popularity since first being introduced by the Balanced Budget Act of 1997. Here are nine reasons why. 1. Low or $0 Monthly Premium Payments. Medicare Advantages plans often have low-cost or even $0 premiums. Costs will vary by plan, so it’s important to shop around. You will continue to pay the Part B premium ...
What is Medicare Advantage?
Most Medicare Advantage plans are coordinated care plans. That means that all your care is brought together under one umbrella so that it can be seen as a whole. The goal is to improve your health outcomes, avoid overlapping tests and procedures and promote clear communication.
What is Medicare Made Clear?
Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.
What is the financial protection of Medicare Advantage?
Financial Protection. Medicare Advantage plans provide a financial safety net due to a set annual out-of-pocket limit. If your costs reach the limit, then your plan covers 100 percent of your Medicare-covered health care costs for the rest of the year.
What is primary care oversight?
Oversight by your primary care provider and access to an extensive network allow you to quickly see providers and specialists for the care you need. Your primary care provider can easily refer you to the services you need.
Does Medicare cover dental, vision, hearing and fitness?
Dental, Vision, Fitness and Hearing Coverage. Original Medicare doesn't provide coverage for dental, vision, hearing care or fitness. For a simple solution and added health and wellness, most Medicare Advantage plans cover these items as part of their benefit packages. 4.
Does Medicare cover emergency medical care?
You can rest assured that you will get the care you need should you have a health emergency – no matter what state you’re in. All Medicare Advantage plans are required to provide coverage for urgent and emergency medical care throughout the United States.
Why do people choose Medicare Advantage?
1. Benefits. According to laws in the United States, all Medicare Advantage plans are required to provide the same benefits as Original Medicare Parts A and B – at least.
What is Medicare Advantage Plan?
A Medicare Advantage plan, or Medicare Part C, is a plan that private insurance companies sell to those who are eligible for Medicare coverage and already enrolled in Original Medicare Parts A and B.
Is Medicare Part C private or public?
Convenience. Medicare Part C insurance plans are sold by private insurance providers across the country. All Medicare Advantage plans bundle your benefits into one plan which includes hospital, medical care, extra benefits, and prescription drug coverage, if applicable.
Does Medicare Advantage cover urgent care?
Even if your plan requires that you use health care providers and suppliers that are within your plan’s network, Medicare Advantage plans must provide coverage for any emergency or urgent care you need anywhere in the United States. 4.
What if I can't join Medicare Advantage?
If you can’t join a Medicare Advantage plan, you have other options for getting quality, affordable health coverage that includes more than just the basics of Original Medicare. Each of the alternatives to Medicare Advantage listed below is considered a two-payer method of health coverage (Medicare and the other form of insurance are each called a “payer”). Before you read about alternatives, you can learn the basics about how Medicare works with other forms of insurance on the CMS website.
How much does Medicare Advantage cost?
The average Medicare Advantage enrollee who gets prescription drug coverage pays just $36 for their health plan premium (s). This is a very reasonable cost, and many seniors would be willing to pay even more than that if it meant quality coverage. However, it’s important to remember that to get Medicare Advantage, seniors also need to pay their Original Medicare premiums. Most seniors will owe a Part B premium of approximately $145 and a Part A premium of $0 in 2020. However, those with high incomes and those who did not pay into the Medicare system via taxes for an extended period of time while they worked may have higher premiums for Parts A or B.
What is Medicare with Medigap?
Original Medicare with Medigap: Medigap is supplemental insurance offered by private companies that is designed to cover Medicare deductibles, copays, and coinsurance. Coverage for these items can be partial or full, depending on the plan. Seniors pay a monthly premium in exchange for the Medigap policy covering many of their out-of-pocket expenses. There are several kinds of Medigap plans which are heavily regulated by the federal and state governments. Learn more about plan types here .
What is ESRD in Medicare?
End-Stage Renal Disease (ESRD, kidney failure) is the final stage of kidney disease in which a patient becomes dependent on dialysis and needs a transplant. Kidney disease leading to ESRD can be caused by a variety of factors including uncontrolled diabetes, high blood pressure, genetic diseases, autoimmune disorders, and more. Those who are diagnosed with ESRD have special opportunities to join Original Medicare even if they otherwise would not be old enough. You can read about how ESRD affects Original Medicare eligibility if you’d like to learn more. Despite the increased likelihood of being eligible for Original Medicare, however, those who have ESRD have unusually limited opportunities to join a Medicare Advantage plan.
How many stars are Medicare Advantage plans?
Medicare has created a rating system so that patients can see how Medicare Advantage plans perform. A plan rating, which is always between one and five stars, can be clearly seen on the right-hand corner of the plan details on the plan finder. According to a recent CMS study, 81% of Medicare Advantage enrollees are in plans that have a rating of four stars or better in 2020. If you’re looking for a plan in your area, and you realize that the only plans available have ratings of three stars or lower, you’ll want to think seriously about whether or not those plans will be valuable to you.
What is care coordination?
Care Coordination: Care coordination is deliberate communication among healthcare providers, usually managed by a single person who is designated the “coordinator”. D-SNP plans can provide a high level of care coordination, helping doctors, patients, and government agencies work together with maximum efficiency. Care coordination reduces healthcare accidents, duplications, and oversights that have adverse financial and physical effects on patients.
Does Medicare cover mental health?
According to a 2012 study, about one in five seniors struggle with a mental illness and/or a substance use disorder. In many cases, poor health and problems with mobility, chronic pain, and social isolation can exacerbate underlying mental health and substance abuse issues. Original Medicare, in recognition of mental health struggles in older populations, provides many options for mental healthcare, including depression screenings, wellness visits, psychotherapy, and more. For many patients, the level of mental health care provided by Original Medicare may be enough. However, for seniors who have had serious, chronic difficulty with managing their mental health successfully, turning to a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) may offer the extra support required.
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, ...
What is Medicare Part A?
Original Medicare. 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, ...
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.
Do I have to sign up for Medicare if I am 65?
Coverage Choices for Medicare. If you're older than 65 (or turning 65 in the next three months) and not already getting benefits from Social Security, you have to sign up for Medicare Part A and Part B. It doesn't happen automatically.
Does Medicare cover vision?
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 Advantage 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.
Do I need Part D if I don't have Medicare?
Be aware that with Original Medicare and Medigap, you will still need Part D prescription drug coverage, and that if you don't buy it when you first become eligible for it—and are not covered by a drug plan through work or a spouse—you will be charged a lifetime penalty if you try to buy it later. 5.
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.
Introduction
Reason #1 – Better For Budget
- Plain and simple, pound for pound, Medicare Advantage plans help you save money. So, if you have a tight budget and need to keep your monthly costs down, you should consider Medicare Advantage plans. Did you know that the majority of these plans have $0 premiums? This feature means that the Medicare Advantage plan is premium-free. You will only nee...
Reason #2 – Dental, Vision, and Hearing Benefits
- If you are insured under Original Medicare or Medigap plans, they do not provide dental, vision, and hearingbenefits. On the other hand, with Medicare Advantage, you enjoy these extra benefits often without paying additional premiums. These benefits can be valued from $1,000 yearly, all the way up to $3,000, $4,000, and maybe even $5,000 in value, depending on the plan and its usa…
Reason #3 – Bundled Drug Benefits
- Aside from dental, vision, and hearing benefits, Medicare Advantage plans have built-in drug benefits. This feature means that a prescription drug plan, also called Medicare Part D, is often already part of the total package, at no additional cost to you. How much does this save you? On their own, prescription drug plans often cost $30 to $40 a month. So, that’s a potential $500 in y…
Reason #4 – Flexibility
- Medicare Advantage plans have flexible plan types. With the wide variety of plan types, the marketplace is pervasive and has different strokes for different folks. For example, if you are not overly particular about which doctors you see, enroll in an HMO plan. But, if you prefer the freedom of choosing doctors, try using a PPO or a Private Fee-For-Service plan. When some peo…
Reason #5 – Plan Benefits Are Getting Better Each Year
- Lastly, Medicare Advantage plans are improving every year. The program progressively gets better and better as private insurers compete for your enrollment. Based on statistics, MA enrollments grew by 9 percentbetween 2019 and 2020 and are projected to continue to grow. Medicare Advantage plans have adapted to the needs of the pandemic. The latest data shows that more A…
Final Words
- Since Medicare Advantage plans may not fit everyone, you should talk with a licensed specialist if you are still unsure about MA plans. If you are confused and need more information, the team at CoverRight can easily help you. We are just a phone call away. If you find this content helpful, you can find more blog articles here.