Medicare Advantage Plans: What You Need to Know


Uncertain about the details of Medicare Advantage? Here’s what you need to know.

The Medicare open enrollment period, running from Oct. 15 to Dec. 7 annually, is now underway. This gives you the chance to make adjustments to your current Medicare coverage. One potential change worth considering is transitioning from original Medicare (Parts A and B, along with a Part D drug plan) to a Medicare Advantage plan. This shift could provide you with enhanced coverage and potential savings on healthcare expenses. If you’re still unsure about how Medicare Advantage plans operate, here are some crucial points to consider:

  1. They must cover all the services included in original Medicare.

When you sign up for a Medicare Advantage plan, you’re guaranteed to receive, at minimum, the same level of coverage offered by original Medicare. While some may be enticed by the potential cost savings of an Advantage plan, it’s important not to compromise on essential services for the sake of saving money.

    2. They often include additional services.

Dental care, eye exams, and hearing aids are generally not covered by original Medicare, despite being common expenses for seniors. Medicare Advantage plans frequently offer supplemental benefits in addition to what original Medicare provides. In fact, most Advantage plans include dental coverage, and many also cover eye exams and hearing aids. Some plans even offer extra perks like paid gym memberships and meal delivery services.

    3. They can be more cost-effective.

Enrolling in a Medicare Advantage plan requires paying a premium for Part B, and in some cases, an additional premium for the Advantage coverage itself. However, your overall costs under Medicare Advantage may still be lower than under original Medicare. Some Advantage plans even have a $0 premium. It’s crucial to carefully review the specific benefits and costs of each plan in your area.

   4. They can come with more limitations.

Original Medicare allows you to see any provider that accepts Medicare. With Medicare Advantage, you’re typically restricted to a specific network of providers. This could potentially make it more challenging to receive the care you need. Additionally, provider networks may change from year to year, so even if you find trusted providers within your plan, there’s no guarantee they’ll remain in-network.

   5. Plan rules and benefits can change on an annual basis.

Not only can providers shift from being in-network to out-of-network with a Medicare Advantage plan, but the plan itself may undergo changes in terms of costs and benefits each year. Once you’ve enrolled in a plan, it’s essential to review any modifications annually. The positive aspect is that you can always switch to a new plan during open enrollment.

If you haven’t delved into the details of Medicare Advantage, you might be overlooking valuable benefits. Alternatively, original Medicare may still be the better choice for you. With open enrollment upon us, now is an opportune time to explore your options for an Advantage plan and determine if a switch could be advantageous.

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