5 Reasons to Consider a Medicare Advantage Plan
Two-thirds of Americans report being deeply stressed about finding the right health insurance. Adults across income levels worry that they won't find the right coverage or that they won't be able to afford the coverage they need.
These fears can hold true even for individuals eligible for coverage through programs such as Medicare and Medicaid. With so many options to choose from, it can be challenging to decide which one is right for you.
If you're trying to choose coverage, a Medicare Advantage plan may be right for you. Keep reading to learn why now.
What Is Medicare Advantage?
Medicare Advantage is the name given to a distinct category of health care plans. Medicare Advantage plans:
Are offered by private insurance providers who have contracted with Medicare
Cover all benefits included in Medicare Part A and Part B
Are alternatives to enrolling in the original Medicare program
Typically include prescription drug coverage
Like other types of health care insurance, Medicare Advantage plans come in a variety of forms. These include Health Maintenance Organization (HMO) plans, Private Fee-for-Service (PFFS) plans, and Preferred Provider Organization (PPO) plans. Special Needs Plans (SNPs) may also be available.
Medicare Advantage should not be confused with Medigap. Medigap policies are supplemental coverage that works with the original Medicare program. Medicare Advantage, by contrast, is an alternative to the standard Medicare program.
Who Qualifies?
Medicare Advantage plans are open to anyone who:
Is enrolled in Medicare Part A and Part B
Lives in the region covered by the plan in which they are seeking to enroll
Does not have End-Stage Renal Disease
Benefits
Medicare Advantage plans offer enrolls unique benefits. Here are the top five benefits everyone shopping for health insurance should know about.
1. It Provides More Comprehensive Coverage
By law, Medicare Advantage plans must cover all of the same benefits included in Medicare Parts A and B. This includes:
Preventative care
Free wellness visits
Screenings for cancer, cardiovascular disease, diabetes, and mental health conditions
Annual flu shots
Most Advantage plans, however, cover much more than just the bare minimum legally required. They often cover:
Prescription drug coverage
Dental insurance
Coverage for hearing and vision care
Free or discounted gym memberships
An Advantage plan rolls all these types of coverage into a single plan. This minimizes gaps between coverage and ensures that policyholders have the insurance they need when they need it.
2. It Has You Covered in an Emergency
Nationally, Americans make 139 million visits to emergency rooms every year. These visits are notoriously pricey. In fact, the cost of emergency and urgent care visits have gone up by 176 percent in the last ten years.
One of the great benefits of choosing an Advantage plan is knowing that your care will be covered in an emergency situation. You can count on your plan covering:
Emergency room and urgent care visits anywhere in the country
Timely treatment for sudden illnesses and injuries
Hospital stays
Skilled nursing facility stays
Follow-up visits with your provider
Hospice care
Some home health care services
Advantage plans tend to leave patients with lower out-of-pocket costs for these types of care than original Medicare.
3. It's Easy to Understand
One of the most attractive benefits of Advantage plans for consumers is that they are easy to understand. Advantage plans are typically structured the same way that private insurance plans are.
Policyholders choose between various options for plans and select the one that best meets their needs. They can change their plans during set enrollment periods each year. The terms, deductibles, copays, and other functions of the plan work in familiar ways.
This makes understanding how Medicare Advantage works simple. That reduces enrollee stress and allows policyholders to get the most out of their plans.
Tracking your costs can also be easier with Advantage plans. Under the original Medicare program, users are billed separately for:
Part A premiums, deductibles, and copays
Part B premiums, deductibles, and copays
Part D coverage
Medigap coverage
This can lead to piles of bills to check, follow up on, and pay. That can be time-consuming and stressful.
Advantage plans roll all coverage costs into a single premium and one deductible. Users will be billed for a single copay fee that covers all care received per injury, illness, or treatment. This saves time and stress and enables policyholders to spend more time doing what they love and less dealing with insurance concerns.
4. It Has Limits on Out of Pocket Costs
When it comes to the cost of insurance, there are two primary types that policyholders worry about: premiums and out-of-pocket expenses. Premiums are generally consistent, well laid out, and easy to plan for. Out-of-pocket expenses are not.
What you pay out-of-pocket can skyrocket during expensive health crises or emergencies. This can leave even insured individuals drowning in medical debt.
Medicare Advantage plans take the anxiety out of out-of-pocket expenses by capping the total amount you will pay each year, regardless of how much care you need. The specific limit can vary by plan, but the maximum cap in 2020 was set at $6,700.
This certainty helps policyholders on limited budgets plan ahead and offers peace of mind. It can also be a financial lifesaver for individuals with chronically high medical bills that might otherwise put them at risk of bankruptcy.
5. It Offers Coverage and Convenience
Medicare Advantage plans combine the coverage Americans need with the convenience they want. They make it easy to:
Find a plan that fits your needs
Enroll in coverage
Estimate and manage health care costs
Handle health care claims
Achieve peace of mind about your health and health care coverage
Advantage plans also provide all of those benefits in one spot. Policyholders never have to juggle multiple plans or providers. They don't have to keep track of numerous policy numbers, dates, or payments.
Explore Your Options
A Medicare Advantage plan can offer you the coverage and peace of mind you need. Explore the plan options open to you using our interactive online tool now. Or subscribe to our mailing list to receive helpful reminders, updates, and educational information about Medicare Advantage plans in the future.
