5 Reasons to Join a Medicare Advantage Plan

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August 3, 2022

Medicare Advantage

Original Medicare does not cover dental, vision, or hearing care. You might want to sign up for a Medicare Advantage plan to get these benefits. Some programs also cover things like transportation or daycare for adults. First, check the plan’s details to see what services are covered. Then you can compare what each program gives you and how much it costs.

Cost

Costs for Medicare Advantage vary from state to state. Part A helps pay for hospital stays, skilled nursing care, and health care in the home. Most people won’t pay more than $274 per month for Medicare Advantage, and Part B can cost up to $499 per month, depending on how long they’ve worked. On the other hand, Medicare Advantage premiums are paid straight to a private company. But Part B costs more, so you might want to consider other options that will save you money.

Different companies offer Medicare Advantage plans with different cost-sharing options. Some plans have very high deductibles, while others have much lower ones. For example, a PPO may have a higher monthly premium than an HMO. Some plans have lower premiums, but you may have to pay more for prescription drugs if you choose that plan. Compare programs because some have higher deductibles than others. Use a Medicare comparison tool to determine the most affordable plan. You can select Advantage plans with high, medium, or low prices and compare the estimated cost per year.

Benefits

The best parts of traditional Medicare are combined with extra benefits in Medicare Advantage plans. This type of health insurance has better health outcomes and lower premiums. For example, a recent study found that people with Medicare Advantage went to the hospital, went to the emergency room, and stayed in the hospital 23% less often than people without Medicare Advantage. People who sign up for this type of health insurance and use its network of doctors and hospitals can also save money on their costs.

The Center for Innovation in Medicare Advantage found that traditional Medicare costs taxpayers more and buys less health care than Medicare Advantage. So, they say more people should sign up for Medicare Advantage plans. In addition, CEO of the Pacific Research Institute and Thomas W. Smith, Fellow in Health Care Policy Sally C. Pipes says that Medicare Advantage plans are better for people who are eligible for both Medicare and Medicaid. Pipes has also written a book that criticizes the current Medicare system, in addition to these findings.

Access

You can sign up for Medicare Advantage plans at certain times. One of these times is the 5-Star Special Enrollment Period (SEP), which lets you join a program with a good star rating and change it later. The first time you can sign up is three months before you turn 65, and it lasts for seven months. Then, you have to sign up for Medicare again every year.

There are three types of Medicare Advantage plans HMOs, PPOs, and Special Needs Plans. Special Needs Plans are made for people with long-term health problems, disabilities, or who live in an institution. They might not cover prescriptions and might only cover over-the-counter medicines. Special Needs Plans are like general enrollment plans but can offer more benefits, such as prescription coverage. On the other hand, HMO-POS plans offer both in-network and out-of-network benefits and may not cover prescriptions.

Coverage for prescription drugs

Part D is for prescription drugs. During a plan year, some procedures make small changes to their list of drugs, but they usually don’t take drugs off the list or move them to a higher tier. This is because changes may be needed to make the medication safer or because there is a generic version.

The most famous part of Medicare Advantage plans is Part D, which covers prescription drugs. Some of these plans offer the best coverage for prescription drugs. Most of the time, the drug benefit will pay for 80% of the cost of covered prescription drugs. Also, even if the plan does not cover a medication, the program will often reimburse the member for the rest of the cost.