What are Medicare Advantage Plans and Should You Have One?
You might think signing up for Medicare is as simple as filling out an enrollment form when you turn 65. But actually, you have a number of choices to make regarding your coverage. While choices can be a good thing, and lead to coverage that better suits your situation, it does mean that you have a bit to learn about the different Medicare plans available to you.
Your first choice will involve choosing between Original Medicare or a Medicare Advantage plan. Original Medicare is composed of Parts A and B, or hospitalization insurance plus regular health insurance. Part A is free to most people, while you pay a premium for Part B.
Medicare Advantage plans roll both of those plans into one plan, and often include prescription drug (Part D) coverage as well. These plans are managed by private health insurance companies, but they must meet certain standards set forth by Medicare.
So, what is the difference between Original Medicare and Medicare Advantage?
With Original Medicare, you can access care from any facility or provider that accepts Medicare (and most do). But you are subject to deductibles and a 20 percent co-payment on your Part B benefits.
On the other hand, Medicare Advantage functions much like other health insurance plans you might have used in the past. You access care through a network of providers who have agreed to accept your plan’s payments. You will make co-payments based upon each individual service and how your plan is structured. Some beneficiaries prefer to have one, comprehensive plan that is easier to understand. Plus, many Advantage plans also include coverage for things like prescription drugs or even dental and vision services.
Advantage plans also include an out-of-pocket spending cap, which can help you to avoid unmanageable medical bills. Prescription drugs are calculated separately.
If you do choose to enroll in an Advantage plan, you now face another series of decisions as you shop for a plan. But that’s why we’re here to help. Give us a call to discuss your options with regard to Medicare Advantage plans, and we can help you compare the different plans available to you.