A Medicare Advantage plan combines all Original Medicare benefits, including Part A and Part B and, in some cases, Part D, into a single plan.
Part A covers skilled nursing facilities, hospice, inpatient hospital care, surgeries, and lab tests, while Part B covers durable medical equipment, outpatient care, and preventive services with a 20% coinsurance. Prescription drugs are covered under Part D if you elect to receive the coverage. Medicare Advantage plans are always a better option than Original Medicare since it replaces the Part B 20% coinsurance with only some small co-pays and cost sharing.
Before you decide to acquire a Medicare Advantage Plan, learn about the pros and cons of Medicare Advantage Plans in the following sections.
Additional Benefits of Medicare Advantage Plans
Medicare Advantage plans merge all the benefits of Original Medicare into a single policy. Most Medicare Advantage plans have a $0 premium. This means you will only have to pay the Part B premium. This makes a Medicare Advantage plan more inexpensive than adding a Medicare Supplement plan to your Original Medicare.
The greatest benefit of a Medicare Advantage plan is that it eliminates the 20 coinsurance on Part B in favor of some small cop-pays and cost sharing. This means that instead of having to pay 20% of the bill yourself (which can get very expensive), you will only be subject to co-pays and cost sharing. For example, it may cost you $20 to see a specialist of $180 for an ambulance ride. For a full list of co-pays, you will want to see the plan’s Summary of Benefits.
Medicare Advantage plans have a maximum-out-of-pocket dollar amount that ranges from around $3,500 – $8,000 depending on the plan. This means that if you have a really bad year and all of your co-pays and cost sharing adds up to the maximum-out-of-pocket limit, you are done paying and the plan will cover everything in full for the rest of the year.
Medicare Advantage plans also have extras that are not offered by Original Medicare. They come with benefits like dental, vision, hearing, gym memberships, over-the-counter reimbursements, meals, etc. For a full list of extra benefits, you will want to see the plan’s Summary of Benefits.
Depending on your area and whether you elect to take prescription drug benefits, some Medicare Advantage plans even give money directly back to your Social Security check every month.
In general, Medicare Advantage plans are a better choice for healthy people who typically have less than $3,000 in annual out-of-pocket expenses. If you visit the doctor frequently or travel frequently outside your coverage area you may want to choose Original Medicare and purchase a Medicare Supplement plan to help with deductibles and co-pays.
There you have it! These are the benefits of a Medicare Advantage Plan. If you want to apply for any Medicare plan, Info65.com has tons of information to help you. We assist you in applying for Medicare and Social Security for the first time. If you are already enrolled, we would be happy to review your current plan and make any changes you might need. If you have any questions about the benefits of these plans, please call us at (888) 308-8311.