I don’t sell Medicare Advantage plans or any other type of insurance. So, though this article is centered on the positive aspects of a Medicare Advantage Plan, I’m not saying you should or shouldn’t buy one. I’m simply pointing out its advantages (excuse the pun).
Remember, Medicare For Boomers is an informational website only. You should consult an insurance professional when you decide whether to go with a Medigap (Medicare Supplement) policy or an Advantage Plan (Part C).
That being said, I’m writing about Medicare Advantage plans because so many negative comments can be found online by people who bought Medigap plans and feel it necessary to justify their decision by telling those that chose Advantage plans how wrong they were.
Let me begin by saying that Medicare Advantage plans are excellent choices for some seniors, just like Medigap plans are for others. We all need to decide for ourselves what type of plan works best for us, not for someone else.
10 Pluses of Medicare Advantage Plans
1. You can’t be turned down for coverage
Unlike Medigap plans in most states, Medicare Advantage plans can’t deny your application for coverage because of pre-existing medical conditions. Carriers can’t ask health questions on their applications, meaning you can’t be denied coverage.
2. Low monthly premiums
Many carriers offer low or even $0 plan premiums. Even though you can have greater out-of-pocket expenses with Advantage plans compared to Medigap plans, the lower premium choice may be worth it for healthy seniors who might not visit the doctor as often or are on a strict budget.
3. Out-of-pocket maximum
If you only have Medicare Part B, the 20% you’re responsible for doesn’t have a dollar limit, which can leave you with big bills. A Medicare Advantage plan has an annual out-of-pocket maximum, no matter how much your medical expenses cost. It’s nice to know that with an Advantage play your costs will never exceed a certain amount.
4. No rate increases because of age
With a Medigap pan, you might face a premium increase due to your age. Medicare Advantage premiums will not increase as you get older. You’ll pay the same at age 80 that you did when you were 65. This is very nice for seniors on a fixed income.
5. You can change plans every year
If you’re not happy with your Advantage plan, you can change plans twice a year. Every year, you receive an Annual Notice of Change letter which gives details about any changes to your plan during the upcoming year. Don’t like those changes? Switch plans and make sure your healthcare and budget needs are met.
6. Only one ID card
Another plus for Medicare Advantage plans is you only need to carry one ID card with you. Medigap policyholders have to carry their Medicare card and their Medigap insurance policy card, as well as their Part D (prescription drugs) card.
7. Extra benefits
Some carriers offer additional benefits with their plans, such as Part B premium reimbursement or a gym membership. Carriers aren’t required to provide these, but they often do so they can remain competitive.
8. Networks are not a problem for some seniors
Not everyone has a problem with the network restrictions that come with Medicare Advantage plans. Many seniors have doctors who participate in Advantage plans, meaning Advantage plan members don’t always have to switch providers. Or hospitals.
9. You get to pay as you go
Some healthy seniors would rather pay lower premiums for an Advantage plan than purchase a Medigap plan. In many cases, they rarely go to the doctor and can save thousands of dollars a year, which they can then use to pay out-of-pocket costs down the road. It’s almost a form of self-insurance.
10. Affordable copays/coinsurance with Medicare Advantage plans
The copays and coinsurance you pay for an Advantage plan can be substantially lower than what you pay with Medicare alone. For example, while you might have a daily copay for an inpatient hospital stay, you aren’t immediately subjected to the part A deductible ($1,600 in 2023) like you would be with only Medicare Parts A and B.
Is a Medicare Advantage Plan right for you?
Don’t let critics of Medicare Advantage plans influence your decision on whether to go with an Advantage plan or a Medigap plan. Talk with a licensed insurance agent who specializes in Medicare and make your own decision. You can always change to another plan if you’re unhappy with your initial choice.
