A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with the coverage you would otherwise get from Original Medicare. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through your Advantage Plan and aren’t paid for under Original Medicare.
Considerations:
- Enrollment: You must be enrolled in both an Advantage Plan and a Part B plan.
- Coverage: Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care.
- Costs: In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.
- Network: Depending on your plan, you may have to pay more for out-of-network providers.
- Annual Changes: Prices and coverage on Advantage plans can change yearly, so benefits should be reviewed carefully each year during the Annual Notice of Change period [resource link].
Advantages:
- Comprehensive Benefits: Medicare Advantage Plans may offer extra coverage not included under Original Medicare, like vision, hearing, dental, fitness programs, and drug prescriptions. Most also include Medicare prescription drug coverage (Part D), and recent improvements also include services for the chronically ill.
- Predictable Costs: Advantage Plans often have out-of-pocket maximums, so you’ll know where your ceilings are.
- Convenience: Advantage keeps things simple by organizing everything into a single plan. It works the same way as an employer health insurance plan, making your transition a relatively familiar process.
- Coordination Options: Some plans offer care coordination, which can be helpful for people living with chronic conditions to manage different healthcare services.
- Emergency/Urgent Care: Advantage plans are limited by their service area, but are required to offer emergency and urgent care, even when outside of your plan’s service area. (This applies only within the United States.)
- Telehealth Options: As a response to the COVID-19 pandemic, Advantage plans now offer a wider range of telehealth services, keeping consultations safe and convenient.
Contact us to learn more about how to choose the right Medicare Advantage plan for you.
