Common Medicare Advantage plans include health maintenance organizations (HMO) and preferred provider organizations (PPO). Specialized plans like private fee-for-services (PFFS) plans and medical savings accounts (MSA) are available.
It's wise to take time to compare plans. To explore your options about original Medicare and Medicare Advantage, visit Medicare.gov. You may discover several reasons to switch to a Medicare Advantage plan.
Original Medicare (Parts A and B) are government provided. Medicare Part A covers hospital insurance and most medically necessary care. Medicare Part B covers medical services like diagnostic tests (e.g., x-rays and MRI scans) in addition to preventive care.
Medicare Advantage plan (Part C) is through private insurance plans. These plans combine coverage for hospital costs, doctor visits and other medical services in one plan.
They may offer potential cost savings and more services than original Medicare. Some plans offer post-discharge home-delivered meals after a hospital stay. Other benefits may include vision, dental, and wellness programs that are not covered under original Medicare.
U.S. News and World Report published an article on Medicare vs. Medicare Advantage to help older Americans make the right choice for them. Experts agree that Medicare Advantage plans are better for some seniors than others.
Out-of-pocket Maximums
Original Medicare plan has no out-of-pocket maximum. This means that you pay a percentage of the cost (whether through a lump sum payment known as a copayment or a ratio known as coinsurance).
Medicare Advantage has a mandatory cap on out-of-pocket spending at $6,700. Some Medicare Advantage plans have out-of-pocket maximums that are far lower.
Potentially Lower Coinsurance
Medicare Advantage plans have different premium amounts, coinsurance rates, and annual deductibles. This could result in cost savings compared to your original Medicare plan.
Built-in Prescription Drug Coverage
You may have already noticed that Medicare Parts A and Parts B don't cover prescription drugs. For prescription drug coverage, you would need Medicare Part D. But with a Medicare Advantage plan, prescription drug coverage is usually included.
The average monthly expense for prescription drug coverage under Medicare Part D is estimated at $33. According to the Kaiser Family Foundation, 80% of Medicare Advantage plans offer prescription drug coverage.
There are over 2,000 Medicare Advantage plans available. Medicare Advantage offers potential cost-savings and benefits compared to original Medicare. By comparing plans, you can make the right decision for the best plan for you.
Fall open enrollment for Medicare started on October 15 and runs until December 7.