People with Medicare Part A (hospital insurance) and Part B (medical insurance) can obtain their Medicare benefits differently if they enroll for Medicare Advantage, commonly known as Medicare Part C.
Private insurance firms having a contract with Medicare provide Medicare Advantage plans. These Medicare Advantage plans offer the same level of coverage as Medicare Parts A and B and provide additional advantages.
You might be wondering if you should enroll in a Medicare Advantage plan or Original Medicare. Because Medicare Advantage plans contain significant elements that many people find appealing, you might also like them. Let’s look at some of the key benefits of Medicare Advantage plans.
Medicare Advantage Plans Provide Flexible Service Coverage
In terms of the services coverage, Medicare Advantage plans are more flexible than Original Medicare. Medicare Advantage plans cover all the services provided by Original Medicare, but they can also offer additional coverage. Hearing aids, in-home health visits, eyeglasses, on-call licensed nurses, and gym memberships are examples of extra benefits. Many Medicare Advantage plans now provide Part D coverage (prescription medication coverage).
If you pick Original Medicare and want prescription drug coverage, you’ll need to buy a separate Part D plan from a commercial insurance company.
Another benefit of Medicare Advantage plans is that they provide non-medical supplemental benefits. These benefits include medical appointments, non-emergency transportation, meal delivery to the home, etc. Moreover, they also offer non-professional in-home care, such as bathing, dressing, and cooking.
Medicare Advantage Plans do not Have Premiums or Sometimes and Low Premiums
There are minimal premiums on many Medicare Advantage plans, while others have none. The government covers Parts A, B, and C, but you must pay a premium for Part B, usually from your Social Security. Private insurers may or may not charge a bonus for Part C.
Part C premiums range from nothing to a few hundred dollars per month, depending on selected plans. Depending on your chosen method, you may be eligible for additional benefits at no extra cost.
Service Providers are Highly Efficient.
Medicare Advantage plans save money by referring members to low-cost, high-quality providers. To offer coordinated treatment, many Medicare Advantage plans, mainly HMOs, work with a “care team” led by your primary care physician and include other physicians, nurses, and physician assistants. According to the Agency for Healthcare Research and Quality research, having a “care team” result in higher care quality and patient safety.
Medication therapy management may be available in Medicare Advantage plans that include prescription drug coverage. This type of care coordination may be convenient and beneficial to your health.
Deductibles and Copy payments are Low in Medicare Advantage Plans
A deductible is an amount you must pay out of pocket for medical treatments or medicines before your insurance company begins to pay. Copayments, often known as copays, are set costs for certain healthcare services such as visits to your doctor’s office or an urgent-care facility. If your Medicare Advantage plan involves deductibles and copays, compare them, and think about your health care requirements because they will differ from plan to plan. A health insurance broker who represents various methods can advise you about all the options accessible to you.
Another benefit of the Medicare Advantage plan is providing a private fee-for-service payment system. This system is one in which a provider gets separate pay for each service provided.
Out-of-Pocket Amount is Low
The fact that Original Medicare has no out-of-pocket maximum is a crucial consideration. The medical expenditures you are liable for paying out of pocket under Original Medicare are not capped – they merely keep building up over a calendar year.
They can reach hundreds of thousands of dollars in the event of serious diseases. In contrast, Medicare Advantages plans have an out-of-pocket maximum. After that, you don’t have to pay anything extra for covered services for the rest of the year, no matter how high your actual costs are.
Medicare Advantages Plans Cover Health Equipment
Health and fitness equipment and services, such as gym memberships, meal subscriptions, and telehealth access, may be discounted or covered under your plan.
You Receive Coordinated Treatment in Medicare Advantages Plan
You can get coordinated treatment with a Medicare Advantages plan. All your healthcare professionals may work together and collaborate on your therapy with in-network providers, reducing the number of unneeded tests and lab work.
If you have Original Medicare, you may need to supplement it with Medigap and Medicare Part D coverage to meet all your medical costs. Instead of having many insurers for your health coverage, you’ll have only one with a Medicare Advantages plan, simplifying your healthcare.
Medicare Advantage Plan Act as One-Stop Center
Most Medicare Advantages plans provide both medical and prescription medication coverage. Many companies also manage supplemental services, including vision, dental, and hearing care. Working with a single plan administrator may be more convenient for you.
You Have the Option to Change Your Plans Twice a Year
All Medicare recipients can modify their coverage (October 15 – December 7 of each year). If you join in a Medicare Advantages Plan and then decide you don’t like it, you can change plans. Moreover, you can return to Original Medicare between January 1 and March 31 of each year.
Selecting Medicare Advantages Plan Over Original Medicare
If you determine that a Medicare Advantages plan is best for you, you may browse for available coverage options. Moreover, you can compare programs and apply online.
You may add the prescriptions you presently take to your account to generate more customized plan estimations. Using the drug list generator, you may evaluate your drug costs under different plans. It will allow you to make a good decision before applying for a specific plan.
The plan finding tool for Medicare Advantages plans allows you to see what additional benefits are available quickly. You may use the filters to refine your search if you seek plans with specific features.
Bottom Line
When it comes to Medicare, you have several alternatives to explore. Compared to Original Medicare, Medicare Advantages plans offer more services, more coordinated care, and better value. Working with an insurance broker representing a variety of Medicare Advantages plans will give you the best opportunity to choose a high-quality, low-cost plan.
Medicare Advantage programs may offer more economical coverage than traditional Medicare. To get reimbursement for approved treatments, you must follow the regulations of your Medicare Advantages plan.
