The Pros and Cons of Medicare Advantage Plans

The Pros and Cons of Medicare Advantage Plans
Medicare Medicare Supplement

Medicare Advantage (MA) plans, especially compared to a package that includes basic Medicare, a Part D drug plan, and a Medigap replacement plan, can be a much lower cost Medicare solution. Approximately one-third of Medicare enrollees are currently on Medicare Advantage plans and two-thirds have basic Medicare.

People must pay the monthly Medicare Part B premium in both cases. The standard Part B premium amount in 2020 is $144.60.

In addition, the extra expense of Medicare Advantage plans that requires a Part D plan will be significantly less than what a Medicare Part D plan and a Medigap program would pay for those with basic Medicare.

Moreover, Medicare Advantage plans are allowed to cover restricted costs for dental, hearing, and vision, although basic Medicare is not permitted to cover these items. Gym memberships are also provided by most MA plans.


Also Read: Get to know the basics of Medicare Supplement Insurance


Supplemental Benefits

Medicare Advantage plans have now been required to cover so-called supplementary benefits for the past two years, items that obviously enhance health outcomes, but are not strictly medical in nature.

Medicare Advantage programs are now required to cover so-called supplemental benefits, items that explicitly enhance health outcomes, but are not strictly medical in nature.

Transportation to health appointments, home-delivered meals to people newly discharged from hospitals, and in-home safety items such as bathroom grab bars are items already provided by some plans.

Most insurers are still making small use of new supplementary coverage right now. Before extending them, they want to see how people react to these advantages. This will also provide insurers with the needed cost data so that their policies can be profitably priced in the future.

These advantages are part of a wider emphasis on health care on what is called "social determinants of health"

It is now well-known that by reducing the need for treatment through programs that provide people with better nutrition, transportation to medical appointments, and community enrichment events that combat social isolation, we can save people and the health system tremendous amounts of money.

Right now, if these benefits are important to you, you can use open enrollment to see if there are Medicare Advantage plans that provide them in your state. However, the Medicare Plan Finder does not make this easy, and to find out about their offerings, you will probably need to contact individual insurers.


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Medicare Advantage vs. Basic Medicare

Basic Medicare requires individuals to use, and almost all of them do, every health care provider in the country that recognizes Medicare.

By comparison, their development of restricted health care provider networks with regional coverage limitations is a big way that Medicare Advantage plans can afford to charge less than standard Medicare while also covering more items.

Exactly who's in the network of a plan can be really difficult to figure out. The quality of network directories for insurers was unacceptably spotty.

For this reason, whether the plan's network of physicians, hospitals, and other health services meets your needs is the answer to whether a Medicare Advantage plan is right for you.

With these networks, there have been major issues. Exactly who's in the network of a plan can be really difficult to figure out.  

In addition, when you participate in your plan, a doctor may be on the network, but either the doctor or the insurer may change their minds by the time you need to see the doctor. It is important to put in place better consumer protections against these problems.

In summary, Medicare Advantage needs a serious look if you are OK with the provider network of a plan and its geographic coverage area. If not, a better, but more costly, the option could be basic Medicare.



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Medicare Frequently Asked Questions

What's the Difference between Medicare and Medicaid?


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