2020

Everything we Should Learn About Medicare Advantage Before Choosing a Healthcare Plan

Everything we Should Learn About Medicare Advantage Before Choosing a Healthcare Plan
Medicare is a great offering for health coverage as you enter the golden years of your life.

However, as your 65th birthday draws near, it can be difficult to sort through the often confusing information to determine what plan is best for you.

Many people nearing retirement age are finding success in enrolling for Medicare Advantage. If you've been starting to consider which insurance coverage plan is right for you, here's everything you need to know about Medicare Advantage and what it covers.


How Medicare Works


Before you can figure out drug coverage, you need to have a basic understanding of how Medicare works. Medicare is comprised of four separate parts:

  • Part A - Hospital and inpatient service coverage. This covers everything from visits to the hospital to home healthcare and hospice care.

  • Part B - Outpatient service coverage. This covers doctor's visits, diagnostics, preventative care, specialized therapy, and mental health services.

  • Part C - Medicare Advantage. This covers Parts A and B through an approved private provider, often with components of Part D included.

  • Part D - Drug coverage. This covers your prescription medication, which is not covered by original Medicare.


Parts A and B make up Original Medicare. When you sign up for Medicare in the months surrounding your 65th birthday, it only comes with Plan A and B unless you specify otherwise.

What is a Medicare Advantage plan?


Medicare Advantage is the other moniker for Part C. Within this plan, you'll have everything offered by Parts A and B, as well as some extras. The primary reason for using Medicare Advantage is that it's convenient and covers the gaps of Original Medicare.

The Pros of Medicare Advantage


There are a lot of benefits to using Medicare Advantage. The overarching advantage is that it offers a wide range of coverage with one convenient provider. Rather than delving into Original Medicare to determine where there are gaps while adding Part D to cover medication and considering other supplemental coverage, Medicare offers it all under one umbrella. This also includes things that aren't often included in basic plans, such as vision and hearing coverage.



In many cases, Medicare Advantage is also more affordable than the alternative. As it is offered through private providers, there's more competition to drive down the costs. It's also easier to crunch the numbers, rather than dealing with multiple plans.

Your Medicare Advantage plan will often use a specific network, which creates a streamlined approach to your broader care plan. This can make it easier for you to navigate the healthcare system and will have you working with providers who already communicate with one another.

Cons of Medicare Advantage


At a glance, it looks like Medicare Advantage is a sure bet. However, there are also challenges to consider when going this route.

The main disadvantage of choosing this plan is the lack of flexibility and freedom in selecting your healthcare providers. If the family doctor you've known and respected for years isn't in the designated network, you will no longer be able to use their services.

Portrait Of Four Friends Enjoying A Game Golf

To protect the program, Medicare Advantage has a lot of checks and balances in place. To utilize the services and receive ample coverage, you may be required to obtain referrals or preauthorization before seeking care. This can be a point of frustration for those who want answers and relief.

Medicare Advantage coverage networks are often regional rather than national. To be eligible, you must live in the region where you're seeking coverage for a certain percentage of the year. This is challenging for retirees who plan on enjoying their golden years by traveling.

Which Is Right for You?


Only you can decide what's right for you when it comes to medical coverage. If you plan on staying in a certain area and would prefer to hand over the reins on choosing healthcare providers, Medicare Advantage is a smart choice.

Weigh the options against your individual needs and lifestyle to make the best choice for you.




 
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