Medicare advantage plans combine medicare Part A, Part B and Part D (prescription drug coverage) all into one plan. These are typically referred to as Part C plans.
OUT OF POCKET MAXIMUM
There are pros and cons to choosing a medicare advantage plan. The most important reason to choose a medicare advantage plan is that it limits your out of pocket maximum to no more than $6800 per year. If you are on original medicare there is no out of pocket maximum so your liability is unlimited.
NETWORK PLANS
Medicare advantage plans are network based plans (HMO or PPO) that are administered by a health insurance company. The insurance companies are subsidized by medicare to provide these plans. This is an important item to consider. With medicare advantage plans you are limited to their network of doctors or hospitals. With original medicare you can seek treatment from any doctor or hospital that accepts medicare.
Before you sign up for any medicare advantage plan you can check to see if your doctor and hospital are in their network. You can also check to see if your prescription drugs are covered and what the cost will be. Do not sign up for a plan before checking.
EXTRA BENEFITS
Medicare advantage plans often include a prescription drug plan as well as cover services for vision and hearing that are not included with original medicare. Many plans even offer a gym membership with the plan.
PREMIUMS AS LOW AS $0/MONTH
Many medicare advantage plans have a $0 per month premium. With any medicare advantage plan you still continue to pay your Part B premium so it is not completely free, but you do get the prescription drug plan and all the other added benefits for a very low additional cost.
PROS OF MEDICARE ADVANTAGE PLANS
OUT OF POCKET MAXIMUM
There are pros and cons to choosing a medicare advantage plan. The most important reason to choose a medicare advantage plan is that it limits your out of pocket maximum to no more than $6800 per year. If you are on original medicare there is no out of pocket maximum so your liability is unlimited.
NETWORK PLANS
Medicare advantage plans are network based plans (HMO or PPO) that are administered by a health insurance company. The insurance companies are subsidized by medicare to provide these plans. This is an important item to consider. With medicare advantage plans you are limited to their network of doctors or hospitals. With original medicare you can seek treatment from any doctor or hospital that accepts medicare.
Before you sign up for any medicare advantage plan you can check to see if your doctor and hospital are in their network. You can also check to see if your prescription drugs are covered and what the cost will be. Do not sign up for a plan before checking.
EXTRA BENEFITS
Medicare advantage plans often include a prescription drug plan as well as cover services for vision and hearing that are not included with original medicare. Many plans even offer a gym membership with the plan.
PREMIUMS AS LOW AS $0/MONTH
Many medicare advantage plans have a $0 per month premium. With any medicare advantage plan you still continue to pay your Part B premium so it is not completely free, but you do get the prescription drug plan and all the other added benefits for a very low additional cost.
PROS OF MEDICARE ADVANTAGE PLANS
- Out of pocket maximum of $6800 or less
- Added benefits beyond original medicare such as vision, hearing and dental
- Prescription drug plans included in many plans
- Premiums as low as $0/month
- Can not be denied coverage except for those with end stage renal disease.
- Rates do not differ if you have pre existing conditions
CONS OF MEDICARE ADVANTAGE PLANS
- Limited to network of doctors and hospitals
- Prescriptions may not be covered under drug plan
- Continue to pay Part B premium
In summary, as long as you find a plan that your doctor and hospitals are part of the network, and your prescription drugs are covered, a medicare advantage plan can make a lot of sense.
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