Why Would Someone Choose a Medicare Advantage Plan?

When it comes to Medicare, you’ve got lots of options. But your first big decision is going to be whether you want a Medicare Supplement plan or a Medicare Advantage plan. Everyone seems to have an opinion on this topic, and Medicare Advantage plans have been the subject of much debate. Lots of people argue that Medicare Advantage plans are bad.

So, why would someone choose a Medicare Advantage plan? Medicare Advantage plans have pros and cons, and you certainly can’t believe all the things you hear about them on TV commercials. Nearly 30 million Medicare beneficiaries choose Medicare Advantage over a Medicare Supplement, so they can’t be all bad, right?

It’s hard to separate fact from fiction regarding Medicare Advantage plans, which makes choosing a plan even more difficult. We’ll start unraveling the confusion today by going through a few reasons someone would choose a Medicare Advantage plan.

1. Guaranteed Access to Plans

Medicare Supplements can deny applications if you try to change your plan outside of your Medigap Open Enrollment Period, which lasts for six months after your Part B effective date. Medicare Advantage plans cannot do that. They do not require you to answer health questions, nor do they deny coverage for any pre-existing conditions.

2. Low Monthly Premiums

Medicare Advantage plans are a “pay as you go” option. This means that you’ll have copays and coinsurance amounts due, but it’s also why their premiums are so low. Many ZIP codes in Arizona have at least a few Medicare Advantage plans with $0 monthly premiums. This is in stark contrast to Medicare Supplements, which will cost at least $100 per month just to have the coverage.

3. Controlled Annual Costs

Under Original Medicare (Parts A and B) alone, you have no limit on your out-of-pocket costs. So, while Part B may only have a 20% coinsurance, that 20% could amount to a lot of money if you have extensive treatment. Medicare Advantage plans all have a maximum out-of-pocket or MOOP. Every plan is different, but most plans fall between $2,000 and $5,000 per year.

4. No Age-Related Premium Increases

Most Medicare Supplement premiums increase with age. People who are in their mid-70s or older are probably going to see Medigap premiums in the $300 or more range. Medicare Advantage premiums do not take age into consideration. The plans can still increase their prices due to inflation or the cost of healthcare, but you won’t have to worry about getting charged more just because you’re getting older.

5. Convenient Coverage

Medicare Advantage plans are convenient. Instead of carrying a few insurance cards in your wallet or purse, you’ll just have to carry one. If you don’t have Medicare Advantage, you’ll likely have to show your Medicare card, your Medicare Supplement card, your Part D card, and probably your dental insurance card. If you have Medicare Advantage, all of that coverage comes in one convenient package.

6. Extra Benefits

Extra benefits are what makes Medicare Advantage plans even more valuable. Original Medicare (with or without a Medigap plan) does not offer coverage for vision, dental, or hearing services. It also doesn’t include prescription drug coverage. Medicare Advantage plans can cover all that and more. In fact, many of them include gym memberships, over-the-counter stipends, meal delivery, and transportation.

7. Options to Change Plans

Not in love with your current Medicare Advantage plan? That’s OK. You can change it during Medicare’s Annual Election Period (October 15 - December 7). And remember, there are no underwriting requirements. We encourage all beneficiaries to review their Medicare plans during AEP and allow us to help them shop for even better coverage.

Get Help with Medicare Advantage Plans

We’ve just scratched the surface of Medicare Advantage. Before you decide if it’s right for you, we’ll need to take a deeper dive into the pros and cons. But in many cases, Medicare Advantage is a great fit.

If you’d like to learn more about the Medicare Advantage plans available in Arizona, call the Local Medicare Specialists today!