What are Medicare Advantage Plans?

Medicare Advantage plans are called “Part C” and sold by private insurance companies.  They combine original Medicare (Medicare Part A and Medicare Part B).  Also, many plans offer $0 premiums and also include prescription drug coverage (Part D).   Many plans also offer additional benefits such as vision, hearing and dental.

Pros of Medicare Advantage Plans

Compared to original Medicare, there may be advantages if you choose a Medicare Advantage plan.

  • All In One

Original Medicare only offers two types of coverage: hospital insurance and medical insurance.  If you want additional coverage, you will need to purchase Medicare Part D for prescription drug coverage and Medicare supplement insurance for additional coverage.  However, with a Medicare Advantage plan, your coverage options are all included in one plan.

  • Personalized Options

Medicare Advantage offers different plan types depending on your medical needs and financial situations.  For example, if you have a chronic health condition, an SNP Advantage plan can help with your medical costs. Or if you have Medicare and Medi-Cal, you can choose a SNP Advantage plan.

If you prefer provider freedom, a PPO plan may be more of what you are looking for.  If you want extra services like dental, vision, or hearing, many Medicare Advantage plans include them.

  • Cheaper Cost

Many Advantage plans have no premiums and offer low or no deductibles.  Another advantage of choosing Medicare Advantage is that most plans set limits on the maximum out-of-pocket costs you will pay during a plan year.  For example, in LA and OC, many plans offer the annual maximum out-of-pocket-expenses of about $1,000.

  • Coordinated Healthcare

Many Medicare Advantage plans include coordinated medical care.  This means that your healthcare providers actively communicate to coordinate your care between different types of healthcare services and medical specialties. This ensures you have a healthcare team and helps avoid unnecessary expense and issues like medication interactions.

Cons of Medicare Advantage Plans

While most people are satisfied with their Medicare Advantage coverage, these plans may also have some disadvantages compared to original Medicare.

  • Limited Network

When you choose the no-premium or low-cost Medicare Advantage plan, most likely, it is an HMO plan.  That means you will be limited with the providers you can see.  You will need to select a primary care physician, and your hospitals and providers will be limited to the medical group’s local network.  Also, you will need a referral before seeing a specialist.

Other plan types do give you more provider freedom, though those plans may have higher premiums, copays and deductibles.

  • Complex plans

When you shop for a Medicare advantage plan, you will encounter many Medicare Advantage plan options offered by many insurance companies.  For some people, all these options can feel confusing and often overwhelming.

Shop Smart with an Independent Medicare Broker

With so many choices to make at once – from choosing the right Part to deciding on coverage options, premiums, and insurance companies, you should work with an Independent Medicare Broker.

Working with an insurance broker can save you a lot of headache throughout your shopping process.  That is why it is important to take your time finding your ideal Medicare insurance broker. When you invest that time, you will find someone that you like and trust.  Skyline Benefit is an independent Medicare insurance broker in Orange County with a variety of Medicare Advantage plan options and price points.  You can click here to get an instant quote today or make a virtual appointment with Skyline Benefit’s Medicare team today.

Call us at (714) 888-5116 for a free Medicare Advantage consultation.