16 Oct Read About Several Potential Drawbacks of Medicare Advantage

More than 55 million Americans are currently enrolled in Medicare. The huge government health insurance program is available for seniors age 65 and older, and it consists of four main parts:

  • Part A, or hospital coverage.
  • Part B, which covers medical services.
  • Part C, also known as Medicare Advantage.
  • Part D, prescription drug coverage.

Together, Part A and B are known as “Original Medicare,” because it’s what was originally offered when the program was created under President Lyndon B. Johnson in 1965.

Medicare Advantage, or Part C, is an alternative to the mentioned offering. It allows for program enrollees to receive their Medicare benefits through a private health insurance plan. The main benefit is that approved private insurance plans may be able to offer more coverage options or more specific coverage to a certain health care need than Original Medicare.

These offerings, however, do not automatically make the program better. Medicare Advantage also comes with certain costs and coverage considerations that might not be the best fit for many seniors.

At a minimum, every Medicare Advantage plan has to include Part A and B hospital and medical coverage. While Part A is free, Part B includes an out-of-pocket monthly premium of about $134 per month in 2018 based on the senior. Medicare Advantage plans also come with premium costs, and the required Part B monthly premium still applies. This can end up being quite expensive, especially for seniors who are living on fixed incomes and can no longer work.

Moreover, some Medicare Advantage plans have high deductibles, not counting prescription drug costs. Yet another drawback is that Medicare Advantage enrollees are confined to their plan’s provider network, rather than having access to Part A and B doctors and hospitals all over the country. Supplemental coverage, such as Medigap, would provide additional coverage for items not included in a given Part C plan, but is only available for Original Medicare enrollees.

While Medicare Advantage may be great for some, it simply isn’t a good fit for others. The majority of all Medicare beneficiaries select Original Medicare, while about a third opt for Medicare Advantage. The key is to research the right plan for you based on your health needs. Medicare offers many resources to help you do this. You can learn more on the Medicare website, including using the Medicare tool to research plan benefits.

If Medicare Advantage is right for you, you can enroll during your initial seven-month enrollment period beginning three months prior to your 65th birthday month, during Medicare’s Annual Open Enrollment Period from October 15th to December 7th. Bear in mind that next year, Medicare Advantage enrollment period may be changing and you can learn more here.

Do not wait to ask us your questions on Medicare or any issue facing you as a Florida senior. We are here to support you and ensure that you have the education and information you need both now and in the future.

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