Medicare Advantage Plans

What are Medicare Advantage plan?

Medicare Advantage plans offer a way to get health benefits for individual who are eligible for Medicare. They differ from traditional Medicare Part’s A & B in that an insurance company becomes your primary insurer – not Medicare. The government requires that the coverage be as good as the coverage you would get from Medicare, but the reality is that coverage is very different.  Medicare Advantage plans have HMO, PPO and Special Needs Plan options.

They commercials you see on TV featuring celebrity spokespersons advertising plans to get additional Medicare benefits are referencing Medicare Advantage plans. Most of the major health insurance companies will offer a variety of Medicare Advantage plans with different costs and benefits.

What are the “advantages” of a Medicare Advantage plan?

• Low cost. In many areas Medicare Advantage plans can be had for free. Some even refund part of your Medicare Part B premiums.
• In addition to providing health coverage many will offer prescription coverage in the plan
• Many plans also feature dental, hearing and eye care coverage

What are the disadvantages of Medicare Advantage plan?

• You are required to see providers that are in the network (except for emergencies). This means you will have less providers/doctors available to you.
• You have an annual Maximum Out of Pocket (MOOP) that is thousands of dollars per year. This comes in the form of deductibles, co-insurances and co-pays.
• After your one year “try-out” if you switch back to original Medicare and attempt to get a Medicare Supplement, you will have to answer questions about your health. This means that if you are suddenly in poor health, you will be not be able to buy a Medicare Supplement.

NOTE: When you are new to Medicare part B or turning 65, you can purchase a Medicare Supplement without any health underwriting. With Medicare Advantage plans there is never health underwriting for pre-existing conditions.