Pros and Cons of Medicare Advantage Plans

pros and cons of Medicare Advantage (Part C) plans
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Medicare Advantage plans are an alternative to Original Medicare (Part A and Part B) that can offer many additional benefits. Often, beneficiaries will choose to join a Medicare Advantage plan or keep Original Medicare and add a Medicare Supplement. 

At Malhotra & Assoc. Insurance, our expert insurance agents are here to walk you through all your Medicare coverage options. Read on to learn more about what makes Medicare Advantage different from Original Medicare.

Pro: Additional Benefits for Low Premiums

Original Medicare does not cover dental, hearing, or vision coverage. If you want prescription drug coverage, you have to purchase a separate Medicare Part D prescription drug plan.

Medicare Advantage plans, which offer the same Part A and Part B coverage as Original Medicare, can offer additional benefits such as dental, vision, or hearing coverage and other perks such as fitness club memberships. Many Medicare Advantage plans also cover prescription drugs.

These additional benefits can be built into the plan or offered for a low additional premium added to your monthly premium. Sometimes, these additional benefits can be at no cost to you.

Pro: Most Plans Include Drug Coverage

Prescription drug coverage is critical for any person regularly taking medication. The pharmaceutical companies charge extremely high prices for prescriptions that you need to take daily. Having insurance makes it possible to take care of your health as your doctor orders.

Medicare Advantage Prescription Drug plans, sometimes called MAPD plans, have built-in prescription drug coverage equivalent to Medicare Part D. That means you will be able to view which drugs the plan covers before you commit to a plan, so you can choose a plan that covers the drugs you are taking. When you fill a prescription, you pay the full cost until you have met your deductible. At that point, your plan will cover most of the cost, leaving you with only a small copayment to pay for each prescription.

Con: Limited Doctor Networks 

While under Original Medicare, you can see any health care provider that accepts Medicare. Most Medicare Advantage plans, on the other hand, work with networks of healthcare providers in your region. This may limit your ability to choose which providers you see and can make out-of-network visits more costly.

Con: Yearly Coverage Changes 

Each fall during the Annual Enrollment Period from October 15 to December 7, you have the ability to review your plan options and choose a different plan or even switch back to Original Medicare. This gives you the opportunity to shop around for the best deal.

Con: Higher Cost-Sharing

Medicare Advantage plans vary in their pricing. You may have a higher deductible or higher copayments with a Medicare Advantage plan than you would with Original Medicare. Pay attention to each plan’s deductible and out-of-pocket maximum to get an understanding of how much you may have to pay for your health care under that plan.

Con: No Travel Coverage

Original Medicare does not cover you outside of the United States, except in specific circumstances. Medicare Advantage plans similarly will restrict your coverage area.

Want to know more about Medicare Advantage plans? Talk with our team of Medicare experts to see which type of plan might work best for you.

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