What’s the Advantage of a Medicare Advantage Plan?
Medicare Advantage Plans (Medicare Part C) are offered by private insurance companies that are contracted by the federal government to administer them.
Medicare Advantage Plans cover the same healthcare services as original Medicare Part A and B, with the exception of hospice care. (Hospice services are covered under Original Medicare Part A and B, even if you’re enrolled in a Medicare Advantage Plan.)
A Few Advantages of Medicare Advantage Plans
Cost Savings
-
- Medicare Advantage Plans are subsidized by Medicare so they usually have a lower out of pocket cost.
- The prescription drug coverage may be included with most plans.
- Preventative services are covered with the plan.
- Out of pocket costs are based on usage instead of a monthly cost so most members with average healthcare usage have lower out pocket expenses with a Medicare Advantage Plan than a Medicare Supplement.
- Some Medicare Advantage Plans have Rx benefits that allow for generic prescriptions with no copay.
- Medicare Advantage plans are required to have a maximum out-of-pocket limit to restrict how much financial responsibility the beneficiary is exposed to.
Convenience
- Medicare Advantage Plans generally have the benefits of original Medicare parts A, B, and D all wrapped up into one coverage plan, administered by one company. This makes it easier for the beneficiary because they only need to use one card for all of their health services.
- Medicare Advantage Plans generally have a set schedule of copays for services. Most of the time, a beneficiary will know what the cost of care will be before that service is provided.
- There are no referrals to see specialists for most plans.