Medicare Advantage | Pros, Cons and Myths

Medicare Advantage plans are growing in popularity, but many people don't understand exactly how they work or if they're really a good value, so that's what we're going to talk about today. Pay attention. Medicare Advantage plans are gaining popularity and If you are about to turn 65 or are new to Medicare, you have probably heard of these plans, maybe you know someone who has one and are trying to find out if this is the type of plan right for you. My name. I'm Stephanie apt and I'm an independent Medicare broker. I help seniors across the country navigate the world of Medicare.

We work with both Medicare Supplement plans and Medicare Advantage plans so we can hear firsthand from our clients what they like and what they do. They don't like all these different types of plans, so today I'm going to dive into some of the biggest

pros

and

cons

to

cons

ider when it comes to deciding whether or not to enroll in a Medicare Advantage plan and at the end of the video. I'm also going to debunk some common Medicare Advantage

myths

, so hang in there and I want to take just a second to ask you if you find value in this video.

Take a moment and hit the subscribe button. You can also like it. video and definitely leave your comments below, we always like to read them now. Medicare Advantage plans are advertised more now than in the past, especially in the fall during the annual enrollment period, but what exactly is a Medicare Advantage plan? Medicare Advantage Plans Also known as Medicare Part C, these are plans offered by private insurance companies to Medicare beneficiaries and these plans typically include medical and hospital coverage. They usually also include Medicare Part D drug coverage, and some CAIR Advantage plans also include additional coverage. benefits like dental and vision services that are not covered by Original Medicare, basically, Medicare Advantage plans are an alternative way to receive your Medicare benefits and I say alternative because if you enroll in a Medicare Advantage plan you no longer have Original Medicare a and B since your no longer have insurance, so Medicare Advantage plans are also known as Medicare replacement plans because these Medicare health plans replace your Original Medicare benefits, so let's go ahead and look directly at the

pros

and cons Of the Medicare Advantage Plans You'll Want to Consider Pro.

The number one Medicare Advantage plans tend to have very low costs in many areas, you can get a Medicare Advantage plan that includes prescription drug coverage for zero dollars a month. Well, how can that be? How can these plans cost zero dollars a month? Medicare Advantage plans are funded. by the government and when a Medicare Advantage plan contracts with Medicare, it is given a set amount of money to cover expected costs for its average members, so if the insurance company can save money on expected costs, e.g. by requiring you to use a fixed network of providers, many times you know that they pass those savings on to you and in the form of a zero dollar monthly premium and it is important to know that Medicare Advantage plans are not actually free, so Even if it says zero dollars a month, you still have to pay.

You will continue to pay your Medicare Part B premium generally and will also pay copayments, coinsurance, and deductibles for your medical services when you use the plan. Another

advantage

of Medicare Advantage plans is the additional benefits you can find in a Medicare. Advantage plan that may not be covered by Original Medicare, things like dental and vision benefits that are not typically covered by traditional Medicare are often included in a Medicare Advantage plan. Some Medicare Advantage plans also include meal delivery services if you are discharged from the hospital and Transportation services are also not covered by all Medicare Advantage plans, but some Advantage plans do include some of these additional benefits.

Finally, with a Medicare Advantage plan you get an all-in-one Medicare plan for many people, this is not the case. necessarily a professional, but I've talked to a lot of seniors who really like to have one card that they use at the doctor, at the pharmacy, at the dentist, so that they really get all those benefits in one plan and only one card that Now While we've reviewed some of the

advantage

s of Medicare Advantage plans, let's talk about some of the disadvantages of Medicare Advantage plans. Medicare Advantage plans are calendar year contract plans, so when you enroll in a Medicare Advantage plan, you generally enroll in a plan that you must stay with for that entire calendar year, and as we mentioned before, Medicare Advantage plans They replace your Original Medicare benefits.

Now, with Original Medicare, you have the freedom to choose your own providers and are covered nationwide, but with Medicare. On the Advantage plan, you are using an established network of providers who contract with that plan, so you are a little more limited to one network of providers; It is also possible for doctors and hospitals to go in and out of network with that plan throughout the year. Another disadvantage of Medicare Advantage plans would be unexpected medical bills, while many Medicare Advantage plans have low monthly premiums that you pay over time. It works in the form of copayments and coinsurance for your medical services and you will pay those out-of-pocket costs until you have reached the plan's goal or the plan's out-of-pocket maximum in 2020, the standard out-of-pocket maximum for Medicare Advantage plans is six thousand. seven hundred dollars a year and that's for network services - it could be higher for out-of-network services and this is a disadvantage for some people because if you have an unexpected stay in the hospital, for example, or you have to start seeing a specialist, you could often face thousands of dollars in medical bills that you may not be prepared for Another potential disadvantage with Medicare Advantage plans is the need for prior authorizations, now traditional Medicare or Original Medicare does not really require prior authorizations for Most services, if deemed medically necessary by your doctor, are generally covered. through Original Medicare but with Medicare Advantage plans prior authorizations are much more common.

Studies have shown that four out of five Medicare Advantage enrollees are in a plan that requires prior authorization for at least one service. Most of the time we see these prior authorizations for more expensive services. medical services, things like hospital stays, durable medical equipment, or Part B drugs, these will be some of the types of things that might require prior authorization with a Medicare Advantage plan and this is something that can be especially frustrating for our clients depending on What I have heard because you and your doctor may have a treatment plan in place or a test you would like to have done or a procedure and your Medicare Advantage provider may not optimally approve prior authorizations.

They are there to help reduce medical expenses, but they are a disadvantage to consider if you are looking for Medicare Advantage plans now that we have talked about some of the advantages and disadvantages of Medicare Advantage plans. I want to debunk some very common Medicare Advantage

myths

. Number one is that people think that their Medicare Advantage plan will pay them their Part B premium, and this is generally not the case. There are certain Medicare Advantage plans in certain areas of the country that provide something called a Medicare Part B premium reduction. but the vast majority of Medicare Advantage plans require you to continue paying your Medicare Part B premium.

Myth number two. Medicare Advantage plans offer better prescription drug coverage than Original Medicare with a Part D drug plan separate from Medicare overall. Medicare Part D coverage, whether you get it through a Medicare Advantage plan or whether you get it through a stand-alone Medicare Part D drug plan, is very similar; everyone has an initial coverage period. without coverage have catastrophic coverage so they really meet the same criteria there and you don't. You won't necessarily find superior drug coverage in a Medicare Advantage plan compared to a standalone Medicare Part D drug plan. The third myth I want about talk is the idea that you can switch from the Medicare Advantage plan to the Medicare Supplement plan each year. during the fall annual enrollment period and this is not necessarily true either.

Medicare Advantage plans are not medically insured, they are available to any Medicare beneficiary, and each year between October 15 and December 7, Medicare beneficiaries can enroll in a new Medicare Advantage plan or change. from one Medicare Advantage plan to another, Medicare supplement plans, on the other hand, letter plans like plan G and plans that work alongside Original Medicare, those plants are generally medically underwritten with Medicare supplement insurance once You have turned 65 or just To get into Medicare Part B, you generally have to be healthy enough to qualify for a Medicare Supplement plan, so when it comes to switching back and forth, it's important to know that if you're in a Medicare Supplement plan, it generally can change.

When you switch to a Medicare Advantage plan, you have one chance each fall during that annual election period that begins October 15 and runs through December 7, but if you're in a Medicare Advantage plan and then you want to switch to Original Medicare. and add a Medicare Supplement plan, you will usually have to go through a medical evaluation and it will depend on your health whether you can qualify or not. In general, Medicare Advantage plans are very good for some, not so good for others, and it really depends on your specific needs and the plans available in your specific area whether this type of coverage will be a good option for you when you are on Medicare.

If you would like to know more about the Medicare plans that are available in your area or are interested in some free, no-obligation quotes, please feel free to contact us. You can call us at the number that appears at the bottom of the screen. Thank you very much for watching and we'll see. See you soon