What You Should Know About Medicare Advantage Plans

Medicare’s aim, since 1966, has been to provide Americans over 65 years old with health insurance. To some extent, it also covers those younger than 65 who have disabilities, as well as a select number of illnesses.

Medicare Part A and Part B are well known and you have likely heard of them. Part A covers hospital stays, hospice care, or home health care, along with medicine. Part B covers outpatient care, such as therapy, physician bills, and medical expenses. Part D covers prescription drugs. What, then, is Part C?

Part C is also known as “Medicare Advantage.” Private companies offer Medicare Advantage while the government handles Medicare Part A and Part B (also known as Original Medicare or Traditional Medicare).

What Does Medicare Advantage Cover?

Medicare Advantage provides an alternative method of obtaining health insurance via non-government companies. The government requires that Medicare Advantage Plans cover everything that Part A and Part B of Original Medicare covers. The plus side is that they often include a wider range of benefits and coverage than included in Original Medicare. These plans can reduce the 20 percent copays and other high costs associated with Original Medicare. This reduction in cost is a primary selling point for choosing Medicare Advantage.

Medicare Advantage plans often cover the following:

• Drug prescription expenses
• Eye exams and related expenses
• Hearing exams and related expenses
• Dental exams and related expenses
• Other wellness related expenses

Not all Medicare Advantage plans are equal, and the number of plans available can make the task of finding a good fit daunting. If you are not sure where to start, try a health insurance planner. Such companies provide counseling sessions to help you find a well-suited Medicare Advantage Plan. Or, at least, can help you narrow your choices down. 

How Much Does It Cost?

Because private companies offer Medicare Advantage, the range of prices is wide. Doing a Google search for “low cost + Medicare Advantage Plan + [Your Location]” will bring up a list of plans available in your area at lower fees.

When communicating with the Medicare Advantage Plan representative, ask what rules you will need to follow. Are the network providers included that you want to frequent? What is the yearly limit for out of pocket costs? Ask what else you should know before making a decision. It is good to note that plans can only change their pricing once a year, on January 1st.

Take a look at this list provided by the Official US Government Site for Medicare. It provides more on Medicare Advantage Plans and what you should think about as you compare plans.

Who Is Eligible?

Eligibility requirements for Medicare Advantage plans are basic. You must be…

• In Medicare Part A and Part B
• In an area that is covered by the Advantage plan you want to switch to
• Free from end-stage renal disease
• 65 years and older

What Should I Know Before I Sign Up?

Yearly open enrollment into Medicare Advantage plans are from October 15 to December 7. So if you are looking to switch to a Medicare Advantage plan in 2017, you will want to apply sometime between October 15 and December 7, 2016. But there are other times that you can enroll as well. To see which date you are eligible for, go to Medicare.gov for clear information on this topic.

One of the most difficult aspects of choosing a Medicare Advantage plan is getting straightforward advice. Want something a bit more visual to help you decide? Medicare.gov utilizes a rating system of 1 to 5 stars for the various plans across the US. What are the ratings based on? Quality of care, accessibility of care, and patient satisfaction. Take a look at their listing before making your decision.

The good news is that you do not have to fear getting locked into one Medicare Advantage Plan. Have you found a certain Medicare Advantage Plan not working out for you? Sign up for a different one during the next open enrollment period that you are eligible for. AARP provides a comprehensive article on the various time periods when you can change plans.