The term Medicare Advantage is thrown around a lot in the news surrounding the healthcare landscape. Yet, despite millions of Americans taking advantage of this program, there’s still a lot of confusion about how it works. Medicare is a federally-funded program that helps those 65 and older receive affordable health insurance. Medicare Advantage is actually Part C of Medicare, and it’s an alternative in which you enroll in health benefits through a private insurance company.
What do you need to know about Medicare Advantage plans? In this guide, we’ll break down everything you should know before you sign up as well as debunk some common misconceptions surrounding Medicare Advantage.
About Medicare and Medicare Advantage
First, let’s take a closer look at what Medicare is exactly and how Medicare Advantage fits into the picture. Medicare, as we mentioned above, is a federal program for those who are eligible. It’s open to people who:
- Are 65 or older
- Have certain disabilities
- Have end-stage renal disease (ESRD)
There are 4 parts that make up Medicare. They are Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). For this guide, we’ll only be looking at Medicare Advantage.
Currently, 34% of Medicare recipients use Medicare Advantage. Medicare Advantage plans are an all-in-one alternative to traditional Medicare. Instead of getting a plan through the government, you’ll choose one through a private company approved by the Medicare program. They’re bundled plans that include Part A, B, and D all within the same private provider.
Why Choose a Medicare Advantage Plan?
Why would someone opt for a private plan instead of traditional Medicare? When you enroll in Medicare Advantage, you still have all the rights and protections of Medicare. In addition, many private companies offer additional benefits like dental and vision insurance that would not have been included with a traditional plan.
However, the biggest reason people choose a Medicare Advantage plan is the cost. There’s much more cost flexibility, and you can choose the level of coverage that you think suits your needs best. You might pay lower monthly costs or less when you visit a provider, and you’ll also have access to a larger healthcare network. All of the things about Medicare Advantage plans make them an ideal fit for those who want more options about their care.
Medicare Advantage Tips
Last but not least, let’s cover some tips about how to make the most out of your Medicare Advantage plan. While it’s true many plans have extra coverage or benefits, you’ll still want to do your research to make sure you’re confident you’ve chosen the best option for you.
Take advantage of routine benefits and drug coverage.
One of the areas that traditional Medicare falls short is with added routine benefits and prescription drug coverage. Traditional Medicare does not cover dental or vision insurance, for example, and these need to be covered with a Medigap plan. When searching for a Medicare Advantage plan, ensure you’re filling in all of these gaps in coverage.
Check the network.
Like the health insurance you got through your employer, Medicare Advantage plans will have their own provider networks. These plans are usually structured like HMOs or PPOs, meaning you get a lower cost if you choose a provider that’s in-network. It’s important to check that any existing doctors you see are covered under your plan.
You can always make the switch.
Finally, you can always make the switch from traditional Medicare to Medicare Advantage. You just need to make sure you switch during either your initial enrollment window or during the Medicare Open Enrollment Period. This is between October 15 to December 7 every year. If you’re not happy with your current plan, don’t be afraid to make a switch.
Live Healthy with Medicare Advantage
Medicare Advantage puts you in the driver’s seat when it comes to your health. You don’t have to accept the government’s plans as one-size-fits-all. You have more options with Medicare Advantage.
Whether you or someone you love is looking into Medicare Advantage, make sure they research their options before deciding on a plan. There’s a lot to know about this program, so the more you learn, the better you’ll be able to make the right decision.
