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As a Medicare beneficiary, you have options. You can choose to get your benefits through Original Medicare (Part A and Part B) or through a Medicare-approved private company that sells Medicare Advantage plans (Part C). Medicare Advantage plans must provide all of the same Part A and Part B services as Original Medicare, but many MA plans include other benefits as well. A Medicare Advantage plan may cost a monthly premium in addition to your Part B premium – but it often includes additional coverage.
What are the benefits of a Medicare Advantage plan? Although Original Medicare helps cover many expenses, it doesn’t cover everything. Therefore, Medicare beneficiaries who choose a Medicare Advantage plan may want additional coverage that Original Medicare doesn’t offer. Most Medicare Advantage plans offer vision, hearing, dental, prescription drug coverage, and/or health and wellness programs, making it an attractive all-in-one plan. As you search for the right coverage for your needs, consider the following benefits of a Medicare Advantage plan.
1. Extra Coverage: Medicare Advantage plans, unlike Original Medicare, may cover hearing, vision and/or dental care.
2. Prescription Drug Coverage: Medicare Advantage plans often include prescription drug coverage (called Medicare Advantage Prescription Drug Contracting, or MAPD). With Original Medicare, in order to get help paying the costs of your prescription drugs, you have to sign up and pay for a separate Prescription Drug Plan (Part D).
3. Fitness benefits: Medicare Advantage plans may cover basic fitness services through a program such as SilverSneakers that gives seniors 65+ unlimited access to thousands of fitness locations across the country.
4. Medicare coverage abroad: Original Medicare can't be used outside U.S. borders, but some Medicare Advantage plans offer coverage abroad.
5. Cost savings and out-of-pocket limits: A Medicare Advantage plan may cost you less because out-of-pocket expenses for Medicare Advantage enrollees are typically capped at $6,700. When you reach your plan's maximum out-of-pocket, your MA insurance plan will pay 100% of additional covered charges incurred in the remaining calendar year. In contrast, Original Medicare doesn't have an out-of-pocket annual maximum limit and may cost you more.
6. Entitled to the same coverage as Original Medicare: All Medicare Advantage plans have to offer at least the same benefits as Medicare Parts A and B and can't charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care.
7. Card Consolidation: Medicare Advantage is typically considered an all-in-one program. A single card will take care of your medical, hospital, and prescription drug benefits. Instead of having three separate cards for your Original Medicare benefits, supplemental insurance, and a prescription drug (Part D) program - you only have one.
8. Pay-as-you-go: Medicare Advantage plans can be viewed as a pay-as-you-go type of plan. A co-payment is made every time you visit a doctor or specialist, have a preventive or diagnostic test, or a hospital stay. Some Medicare Advantage plans have little or no premium, and could potentially save you money compared with a Medicare Supplement Insurance Plan if a doctor is only occasionally seen.
9. May be cheaper than a Medigap plan: Medicare supplemental insurance, also called “Medigap,” is private health insurance that helps pay for health care costs, such as co-payments, coinsurance, deductibles, and coverage abroad not covered by Original Medicare. Medicare Advantage plans usually have a lower monthly premium than Medigap plans. However, it’s not always cheaper. A Medigap plan could actually result in lower out-of-pocket expenses in the long run, depending on your health and coverage needs.
10. Doctors and other providers within the plan’s service network are easily accessible to you: Some Medicare Advantage Plans have network restrictions potentially limiting your access to doctors and hospitals. However, if your doctors and providers are in your network and easily accessible to you, a Medicare Advantage plan may be a good option.
Are you looking for a Medicare Advantage plan? We offer free, accurate comparisons for Medicare Advantage (Part C), Medicare Supplement (Medigap), and Medicare Prescription Drug (Part D) plans. Contact a Medicare.org licensed sales agent at (888) 815-3313 - TTY 711 for a free quote today.
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Blue Cross Blue Shield - Illinois
Blue Cross Blue Shield - Montana
Blue Cross Blue Shield - New Mexico
Blue Cross Blue Shield - Oklahoma
Blue Cross Blue Shield - Texas
Blue Shield of California
Capital Blue Cross
Cigna Health Spring
Premera Blue Cross
Scott & White
Vibra Health Plan
Last Revised 11/15/2017