What is Medicare Advantage?

Get the facts on Medicare Advantage

It seems that no aspect of the Medicare program generates more confusion and questions than Medicare Advantage. If you’re new to Medicare or are considering an Advantage plan for the first time, watch the following video to get the answer to, “What is Medicare Advantage?”.

Plan options for people on Medicare

When you become eligible for Medicare you’ll be confronted with some choices. For some people who have had limited choice in the form of employer coverage this can be a little overwhelming.

Here are your options:

  • Original Medicare – with or without Part D
  • Original Medicare + a Medicare supplement – with or without Part D
  • Medicare Advantage plan – may or may not include Part D

Original Medicare

Includes Part A which is hospital coverage and Part B which is outpatient coverage. Some pitfalls include:

  • Possible high out-of-pocket costs
  • Part D not included (requires additional premium)
  • Many services not covered i.e. dental, vision etc.

Original Medicare + Medicare supplement

You will continue to pay your Part B premium and a premium for your supplemental insurance. Some pitfalls include:

  • Unaffordable for many
  • Part D not included
  • Many services not covered

 Medicare Advantage explained

Medicare Advantage plans are offered by private insurance companies which are contracted and approved by Medicare. You are receiving your Medicare benefits through the private insurance company and are still enrolled in Medicare.

Many people believe that because they have enrolled in a Medicare Advantage plan, they have somehow left the Medicare program. This is not the case.

Another misconception is that an Advantage plan is a Medicare supplement. This is not true. A supplement helps pay your share of covered expenses while receiving benefits from original Medicare.

Medicare Advantage is merely another way to receive your Medicare benefits. The idea was originally, that private companies could be more efficient at delivering benefits while offering more choice.

Many Advantage plans include Part D coverage and are referred to as MAPD plans. MA plans include medical benefits only and you are limited as to which types of plans you can add a stand-alone Part D plan.

As long as plans include Part A and Part B benefits companies are free to design a plan with different options that people may find beneficial. That is why many plans include extra benefits not normally included in original Medicare such as dental, vision, gym memberships etc..

To be eligible for a Medicare Advantage plan, you must:

  • Have Parts A and B
  • Live in the plan’s service area
  • Not have end-stage renal disease

You will pay a premium (sometimes as low as $0 per month) to the private insurance company. When receiving services you may pay deductibles, copayments or coinsurance amounts.

Plans have a maximum out-of-pocket that can change on annually.

Next: Video 2 – Types of Medicare Advantage Plans



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