Medicare is a federal health insurance plan offered to people 65 and older, younger people with disabilities, and younger people with End-Stage Renal Disease. There are two main branches when picking a Medicare plan: Original Medicare vs. Medicare Advantage Plans. Medicare Advantage Plans, also called Medicare Part C, are an alternative to Original Medicare. These plans are offered by private insurers. The difference between Medicare and Medicare Advantage can be confusing at first. To learn whether or not Medicare Advantage is right for you, read on.
Structure of Medicare
Medicare is made up of 4 Parts: Parts A, B, C and D. Part A covers inpatient healthcare services like hospitalization. Part A is mandatory. Part B covers outpatient care, like doctors’ office visits. Part B is technically optional, but most people get it because it covers a vital part of healthcare. You must also purchase Part B if you would like to purchase Part C. Part C refers to Medicare Advantage Plans. These plans are completely optional. Part D covers prescription medications. While Part D is also optional, many people choose to enroll in a Part D plan because prescription medications are expensive and there is a late fee if you do not enroll when you are first eligible.
Medicare Advantage Overview
Medicare Advantage plans are offered by private insurers. First, you have to enroll in Medicare Parts A and B. This ensures that you are covered for many basic healthcare services. You may then enroll in a Medicare Advantage Plan. You have to find the company and plan that best suits your needs. You then apply and, if accepted, pay a monthly premium.
Advantages of Medicare Advantage
People choose to enroll in Medicare Advantage plans because of the bonus features. For example, many Medicare Advantage plans have vision, dental, and hearing insurance coverage. These are major insurance needs that Original Medicare does not cover. They may also have bonuses like gym membership reimbursements, transportation to appointments, or even prescription drug coverage. The actual features vary depending on the insurance company and the plan.
Disadvantages of Medicare Advantage
There are two main disadvantages associated with Medicare Advantage plans. The first is that you are adding at least one more premium to your monthly premium total. In order to enroll in Medicare Advantage, you have to first enroll in Medicare Parts A and B. Most people do not have to pay anything for Medicare Part A, but Part B does have a premium. In 2021, that premium is $148.50 per month. However, the premiums associated with Medicare Advantage can vary greatly, and some plans will have a premium as low as $0, which is definitely more of a positive than a negative.
If your plan does not include prescription drug coverage and you want it, you then have to add Part D, a third premium. The second main disadvantage of Medicare Advantage is that it may limit your choices for a provider. Depending on the type of Medicare Advantage plan you have, your insurance may not be as universally accepted as Original Medicare.
Navigating the world of Medicare Advantage can be confusing. To learn about whether or not this option is actually right for you, give us a call today!