Advantages and Disadvantage of Medicare Advantage Plans

Do you wish to go with Medicare Advantage plans?  In fact, the very first point you must know is that Medicare Advantage plans is operated by the federal government and this is an alternative to Original Medicare. The plans of MA cover all the original Medicare services and also include the Part D coverage. The MA plans provide additional services such as the hearing, dental or vision coverage that the Original Medicare fails to cover.

Here are some questions that cloud the mind of seniors such as:

Here are a few key considerations determining if an MA plan is suitable for you.

  • Lower costs: Paying for Part B premium comes with both options, but with Medicare Advantage plans it comes with additional premiums and becomes less expensive than the Medigap policy premiums that come as an Original Medicare combination. There is a set limit on the pay-out-of pocket money and this cap varies each time. In case you spent maximum amount, there is nothing to pay for the balance of year for covered services.
  • Identical to health insurance: Offers identical as it used to such that the co-insurance, deductibles, physician networks and drug coverage are included in the package.
  • One system: The Medicare Advantage plans are cohesive. There is one system in Medicare Advantage plans that give the beneficiaries the advantage of enjoying everything in one such as Original Medicare, Medigap and Part D. Thus, it is more coordinated.
  • Additional benefits: The Medicare Advantage plans include vision, dental and hearing benefits, drug coverage, etc that are not Original Medicare coverage.

 

Disadvantages

  • More complicated: The Medicare Advantage plans are more complicated with procedures. The managed plans keep healthcare within budget, but overuse is prevented and in case there is a need to overuse there is a need to seek prior authorization for home health care, surgery, medical equipment and hospital stays. Additional proof is a must to pay for such services.
  • Billed before treatment: The MA plans may co-pay prior to treatment. In case of multiple visits to a physician, there may be co-pays as upfront before seeing the doctor or receiving any care.
  • Less freedom: The Original Medicare allowed choosing any physician accepting Medicare. Now, with MA plans there is a doctor, pharmacies and hospitals list as providers and you are expected to visit ‘in-network’.