Understanding how Medicare Advantage works

Understanding how Medicare Advantage works

Zac Burton

Part C of the US federal health insurance plan called Medicare Advantage is probably one of the most popular medical insurance covers. There is a variety of inpatient and outpatient facilities covered in this plan upon paying a flexible monthly premium.

What is Medicare Advantage?
This is an added benefit option to add to your Medicare plan in order to extend the coverage. Like the Original Medicare plan, this one is applicable to the elderly over 65 years of age and the physically challenged. While Medicare covers people with end-stage renal disease, finding support for this condition with Medicare Advantage is not very easy. But you can choose this one to keep the out-of-pocket costs during medical emergencies within a manageable limit.

There are some medical expenses like those in hearing, dental, or vision-related issues that are not covered by the Original Medicare plans. To tackle these and also get coverage on the costs incurred in regular medical visits and outpatient care, Medicare Advantage comes in handy.

What are the Medicare Advantage plans?
The following are the Medicare Advantage plans available:

  • Health Maintenance Organization
  • Preferred Provider Organization
  • Private fee-for-services
  • Medical Savings Plan

How does Medicare Advantage work?
Medicare helps in covering your expenses by paying a monthly charge to the plan provider. The amount paid depends on the chosen plan, the premium, and other factors. You would be able to compare the out-of-pocket expense limits and other such aspects to choose the plan that suits your budget. Remember that there are annual changes in the rules pertaining to the terms of these plans. The requirements for referrals also vary, and this can determine whether you are eligible for insurance coverage.

Advantages and disadvantages of Medicare Advantage plans

Advantages

  • Saves your expenses
    One of the main benefits is that you do not have to bear any surprise expenses. Most of them come with low deductibles and overall costs.
  • Customization
    If the standard plans do not cover your medical expenses, you can choose Medicare Advantage for a more personalized approach. People with chronic problems might find the coverage offered by this plan to be beneficial.
  • Choose coordinated medical care
    To stay in touch with your medical care team and obtain the best services in the form of coordinated care, this plan can be very useful.

Disadvantages

  • The overall premium increases in this case as you would also require the cost incurred in Part A and Part B.
  • The number of providers for Medicare Advantage is less than that for Original Medicare. This reduces the number of options you have for comparing and choosing the most suitable plan.

Cost of Medicare Advantage
Based on the plan you choose and based on whether there is a premium or deductible involved, the cost of Medicare Advantage plans vary. It also depends on the type of Medicare Advantage plan you choose. On average, it is around $60 monthly.

Tips to find the most suitable Medicare Advantage plans
Remember that irrespective of the services you choose, there is a premium involved in most cases.

  • Start by evaluating your medical expenses. If they have been concentrated around things like hearing and dental issues that are not usually covered by the Original Medicare plans, then Medicare Advantage would be a worthy expense.
  • Do you worry more about the out-of-pocket costs during emergencies or the monthly premiums? If it is the former that scares you, you should compare and choose a suitable Medicare Advantage plan today.

Remember that the Medicare Advantage plan is applicable only if you have both Part A and Part B of the Original Medicare plan. And you should be sure whether your provider network accepts managed care plans like this one.

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