Medicare Advantage: How Advantageous Is It?

Discover the private insurance path to comprehensive health care with Medicare Advantage, also known as Medicare Part C.

The Advantages

Medicare Advantage isn't just about basic coverage. It's about enhancing your health options and integrating various benefits into a single plan offered by a private insurance company.

Here's why you might love it:

  • Lower Premium Costs: Medicare Advantage plans often come with lower premiums, sometimes even as low as $0.

  • Part B Giveback: Some plans offer “Part B giveback” options that reduce the amount of Part B premium you pay, but tread carefully as this could mean giving up certain benefits.

  • Extra Benefits: Many Medicare Advantage plans throw in extra benefits at no additional cost. These might include dental, vision and hearing coverage, Part D drug coverage, fitness plans, allowances for over-the-counter items, and meals after hospital stays.

Couple Enjoying Retirement
Couple Enjoying Retirement

The Disadvantages

Although Medicare Advantage has its perks, here are a few issues that give some people pause:

  • Network Limitations: Medicare Advantage plans are network-based, which means not all health care providers will accept every plan.

  • Higher Out-of-Pocket Costs: Compared to Original Medicare with a Supplement, Medicare Advantage plans typically have more copays, potential deductibles and coinsurance for health care services, leading to higher out-of-pocket exposure.

  • Annual Changes: Medicare Advantage plans can change each year, including health care providers leaving the network plus changes to copays, deductibles and maximum out-of-pocket limits.

  • Geographic Restrictions: The availability of Medicare Advantage plans varies by county. If you move, you may need to switch to a plan offered in your new location.

  • Unexpected Alterations: Extra benefits like dental coverage or over-the-counter benefits can be added or removed annually.

The Considerations

Before making a Medicare Advantage decision, here are three things you need to consider:

  • Network Restrictions: It's crucial to ensure that all your health care providers, including routine providers, hospitals and specialists, accept the Medicare Advantage plan you’re considering.

  • Drug Coverage: Unlike Original Medicare with a Supplement, where you can choose from many drug plans, a Medicare Advantage plan typically comes with its own drug coverage. Ensure this coverage fits your medication needs before signing up.

  • Reputation: Because private insurance companies manage your health care with Medicare Advantage plans, their reputation matters. Some may be easier to work with or may require more approval for procedures. Our professionals can share their experiences with different Medicare Advantage providers to help you make an informed decision.

Grandfather and Grandson working on a toy model car

LET'S TALK You’re Not Alone

Choosing the right Medicare Supplement or Medicare Advantage plan can seem daunting, but it doesn't need to be. We're here to make this journey easier.