Medicare Advantage is a part of Medicare that offers an alternative to Original Medicare (Part A and B) plans. These plans, also known as Medicare Part C, combine Medicare Part A and Part B coverage as well as provide the opportunity to possibly add additional coverage, creating more complete health coverage for Medicare beneficiaries.

Should you sign up for a Medicare Advantage plan? Well, the answer relies on the type of coverage you’re looking for. So, let’s take a closer look at the advantages and disadvantages of Medicare Advantage so you can make a more informed decision.

Advantages of Medicare Advantage Plans

Offers More Benefits Than Original Medicare

Medicare Part C plans are required to offer all the benefits covered by Original Medicare, and many Medicare Part C plans offer more coverage. These benefits may include Medicare Part D prescription drug coverage, hearing aids, dental care, vision care, and more.

However, this will typically depend on which type of Medicare Advantage plan you choose. For example, Special Needs Plans (SNPs) are required to provide prescription drug coverage.

May Cost Less

If you opt for a Medicare Advantage plan, you continue to pay your Part B monthly premium, and you may also be responsible for your Medicare Advantage premium, that is, if you have one. The private insurer determines the premium for the plan, which can vary, but some plans may have a $0 premium.

And, if you get premium-free Part A along with a Medicare Advantage plan with no premium, the only premium payment you have to pay is the Part B premium. 

Medicare Advantage plans also limit your maximum out-of-pocket expenses. This maximum out-of-pocket currently in 2021 is $7,550, but this is the upper limit, and some plans will have a lower cap.

It Can Serve as Your One-Stop-Shop

Most Medicare Advantage plans bundle hospital, medical, and Medicare Part D prescription drug coverage. Many Medicare Advantage plans also coordinate the delivery of extra benefits such as hearing care, dental care, and vision care, as mentioned previously. 

Some will even have in-network providers you can visit to receive your care, which would ultimately lower your out-of-pocket costs compared to going to a provider outside of these specific networks.

Disadvantages of Medicare Advantage Plans

Restricted Network

With Original Medicare, you can generally go to any doctor or hospital that accepts Medicare and receive the same level of benefits for Medicare-covered services. Medicare Advantage plans, as mentioned previously, can have in-network providers and may require their members to use these networks to get care and treatment. 

If you receive care outside of this network, your Medicare Advantage plan may not cover your medical expenses unless it is an emergency.

Some Plans Require Referrals

Some Medicare Advantage plans, such as Health Maintenance Organization (HMO) Plans, often require a referral from your primary care physician to see a specialist. They may also ask that you choose a primary care physician that is within their provider network.

Is Medicare Advantage Right For Me?

When it comes to choosing the best Medicare plan, there is no one-size-fits-all solution. Medicare Advantage offers several benefits, such as multiple plan options and convenient coverage. It has its disadvantages as well, such as limiting network providers.

However, at Medigap Supplement Headquarters, we are dedicated to helping you discover which plan works best for you. If you want to compare all your Medicare options and learn about the coverage available to you, reach out to us today!