top of page

Medicare Advantage plans, Yes or No?


Medicare Advantage plans, also known as Part C plans, are a type of health insurance plan offered by private insurance companies that provide Medicare benefits. They are an increasingly popular choice among Medicare beneficiaries, with enrollment growing from 11.1 million in 2010 to 26.4 million in 2021. In this blog, we will explore why Medicare Advantage plans are a good option for seniors and people with disabilities.

First, Medicare Advantage plans offer additional benefits beyond Original Medicare.

While Original Medicare (Part A and Part B) covers hospital stays, doctor visits, and other medical services, it does not cover everything. For example, it does not cover dental, vision, or hearing services. Medicare Advantage plans, on the other hand, often include coverage for these services, as well as prescription drug coverage (Part D), wellness programs, and other benefits such as transportation to medical appointments. This can make a significant difference in the lives of seniors, who often face health issues related to dental, vision, and hearing.

In addition to the extra benefits, Medicare Advantage plans also offer a level of predictability in terms of costs. Original Medicare has no cap on out-of-pocket expenses, which can leave beneficiaries vulnerable to unexpected medical bills. In contrast, Medicare Advantage plans have an annual limit on out-of-pocket expenses, which provides peace of mind for seniors and

people with disabilities.

Furthermore, Medicare Advantage plans can be more affordable than Original Medicare, depending on the plan and the individual's healthcare needs. In 2021, the average monthly premium for a Medicare Advantage plan is $33, which is lower than the average monthly premium for a standalone Part D prescription drug plan ($33.06) and the average monthly premium for a Medigap policy ($182). Many Medicare Advantage plans also offer $0 monthly premiums, which can save beneficiaries money.

Another advantage of Medicare Advantage plans is that they often provide coordinated care.

This means that a team of healthcare providers works together to manage a patient's health, including coordinating appointments, tests, and treatments. Coordinated care can lead to better health outcomes and lower healthcare costs, as providers can avoid duplicative services and unnecessary hospitalizations.

Medicare Advantage plans also offer flexibility in terms of provider choice. While Original Medicare allows beneficiaries to see any provider who accepts Medicare, some providers do not accept Medicare assignment, which means they can charge more than the Medicare-approved amount for services. In contrast, Medicare Advantage plans have provider networks, which can help ensure that beneficiaries receive care from providers who accept the plan's payment rates.

Finally, Medicare Advantage plans offer some protection for beneficiaries who need long-term care.

Some plans offer coverage for long-term care services, such as nursing home care or in-home care, which can be expensive and not covered by Original Medicare. This can provide peace of mind for beneficiaries who may require long-term care in the future.

In conclusion, Medicare Advantage plans are a good option for seniors and people with disabilities who want additional benefits beyond Original Medicare:

  • predictable costs

  • affordable premiums

  • coordinated care

  • flexible provider choice

  • long-term care coverage.

However, it's important to note that not all Medicare Advantage plans are created equal, and beneficiaries should carefully review the details of each plan before enrolling. Factors to consider include the plan's benefits, premiums, copayments, coinsurance, deductibles, provider network, prescription drug coverage, and quality ratings. Beneficiaries can compare plans using the Medicare Plan Finder tool on the Medicare website, or by speaking with a licensed insurance agent.

About Preferred Senior Benefits in Meridian, Idaho

Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818-2523. We can’t wait to help you learn about your options.

6 views0 comments


bottom of page