Medicare Advantage Plans

medicare advantage

Medicare Advantage plans are Medicare health insurance plans offered by private insurance companies, like Humana, UnitedHealthcare, Aetna and others.

MA Plans must provide the SAME coverage as Original Medicare (Part A & B) but all plans offer additional benefits. These EXTRA benefits (not included in Original Medicare) are one of the main reasons why MA plans have become a popular choice.

Why are Medicare Advantage Plans so popular?

Enrollment in MA Plans has doubled over the past decade. In 2020, more than 36 percent of Medicare beneficiaries are currently enrolled in a Medicare Advantage plan. In fact, several states are now over 40% with MA enrollment.

So, why are MA Plans so popular?

  1. Extra Benefits
  2. Zero Premium or Low Premium Plans
  3. All-in-one Approach (Prescription drugs included)
  4. Lower Out-of-Pocket Costs

What are the Extra Benefits?

Let’s face it… we ALL like the EXTRA stuff. Medicare Advantage plans offer extra benefits that aren’t available with Original Medicare (Part A & B).

These Extra benefits could include:

  • Medicare Drug Plan (Part D)
  • Dental Care
  • Routine Vision
  • Routine Hearing Services
  • Fitness Memberships
  • 24/7 Telehealth Services
  • Transportation Services
  • Over-the-Counter Drugs

What does Zero Premium Medicare Advantage mean?

We get this question all the time… is Medicare Advantage free? Unfortunately, MA Plans are NOT FREE but most companies do offer zero premium plans or low premium plans.

Zero premium Medicare Advantage plans don’t have a monthly premium. This means you pay nothing to the insurance company for your coverage. However, you still have to pay for your Part B premiums.

It’s important to check the plans provider networks, drug formularies, and total costs before deciding on if a zero premium plan or low-cost plan is best for you. Sometimes, Original Medicare with Medicare Supplement Plan and Part D Plan make more sense.

What is a All-in-One Medicare Plan?

Medicare Advantage plans are often referred to as “All-in-One” alternative to Original Medicare because MOST plans include prescription drug coverage and extra benefits.

So, with a MA Plan you won’t have to enroll in seperate stand-alone Part D plan since its included. Once again…

Part A + Part B + Part D = Part C (Medicare Advantage)

Do MA Plans have a maximum out of pocket cap?

YES! Unlike Original Medicare, ALL Medicare Advantage plans have out-of-pocket maximums.

For Example: If you have major surgery that costs $15,000 and your maximum out of pocket on your MA Plan is $5,000 – you would only pay $5,000 or less depending other services you might have paid during the year.

Most Popular MA Plan Types

The two most common Medicare Advantage plan types are HMO and PPO. Like all health plans, PPO and HMO plans are approved by Medicare and offered by private insurance companies. Here are the details so you can make an informed decision.

PPO stands for (Preferred Provider Organization) – PPO plans allow you to use providers in and out of the plan’s network. However, services you receive outside the network you generally will have higher coinsurance and copayment costs. Just a few benefits about PPO’s:

  • Flexibility – to see any provider in or out of network
  • Larger Network Size
  • Most often not required to choose a Primary Care Physician
  • Don’t need a referral to see a specialists

HMO stands for (Health Maintenance Organization) – HMO plans require you receive your care from a network of local doctors and hospitals that help with your care. Few benefits about HMO’s:

  • Generally lower premiums
  • Usually low or no deductibles

HMO vs. PPO – Which is better?

Tough question to answer… it really comes down to each individuals situation. Plus, choosing a plan has a lot to do with what plans are available in your area.

Let us help! Click “Get Quotes” and MedicareQuote can help you in your decision.