What Are The Advantages And Disadvantages Of Medicare Advantage Plans?

The Advantages Of A Medicare Advantage Plan

Many Medicare Advantage plans include additional benefits you may need that are not covered by Original Medicare, including:

• Routine dental care, including X-rays and exams.
  
  
• Routine vision care, including glasses and contacts.
  
  
• Routine hearing care, including testing and hearing aids.
  
  
• Prescription drug coverage
  
  
• Wellness and fitness programs, including SilverSneakers^®.

Many Medicare Advantage plans feature low premiums (sometimes $0). Medicare Advantage plans also cap your maximum out-of-pocket expenses for Part C covered services. Once you reach the cap, you pay nothing for the rest of the year. Be sure to compare the Medicare Advantage plans’ costs along with coverage.

How Does Medicare Advantage Compare To Original Medicare?

Original Medicare includes Part A and Part B. Part A covers hospitalization, home care, and other inpatient medical needs. Part B covers only outpatient care, such as doctor visits, medical tests, screenings, and preventive care, which can be a disadvantage if you need more coverage. All Medicare Advantage plans include Medicare Part A and Part B coverage. Many include additional benefits like routine dental care, vision care, hearing care, and prescription drug coverage.

Medicare Advantage Plan Pros And Cons

There are many advantages to choosing a Medicare Advantage plan. In addition to benefits such as dental, vision, hearing, and prescription drug coverage, many Medicare Advantage plans have low premiums — some as low as $0 per month. You’ll also have the convenience of having your benefits combined in one plan.

One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare. And if you sign up for a Medicare Advantage plan with an HMO network, you may need a referral from your primary care doctor to see a specialist. 

Questions To Ask While Comparing Medicare Advantage Plans

Finding the best Medicare Advantage plan may be worth it for the additional coverage. Be sure to ask the right questions to get the most out of the plan you pick. 

• Are your preferred hospitals or preferred doctors included in the Medicare Advantage plan?
  Doctors and hospitals in a plan’s network can change yearly, so it’s best to make sure your family doctor is still in the plan after your initial enrollment. Just ask when you go for a doctor visit.
  
  
• Which prescription drugs are covered?
  You can use our find a drug tool to see what drugs are available in the plan. If you need medications, are they available and affordable under a selected plan?
  
  
• What is the maximum out-of-pocket amount?
  Medicare Advantage plans limit how much their members pay out of pocket for covered Medicare expenses. That amount varies depending on the plan you choose. After reaching the maximum out-of-pocket amount, Medicare Advantage plans pay 100% of eligible expenses. Choosing a plan with a lower out-of-pocket maximum may be preferable to make sure you have coverage for unexpected injuries or illnesses.