It’s no secret that Medicare Advantage is one of the most talked-about topics in Medicare.
These plans are highly advertised and pushed by insurance companies, agents, and brokers.
So the question is…
What is Medicare Advantage, and are these plans good for you?
The reality is that when it comes to these plans, there’s a lot of misunderstanding about how they work.
The advertisements on TV, promotions in the mail, and endless phone calls don’t always tell you the whole story. Instead, they show “zero-premium plan” advertisements but don’t tell you what you will pay if you get sick.
Here’s the kicker:
If you join a Medicare Advantage plan for the WRONG reasons, you will be incredibly disappointed in the coverage, and it’ll cost you a ton of money.
So, let’s talk about the advantages and disadvantages of Medicare Advantage Plans.
What is Medicare Advantage?
Medicare Advantage plans are also called Medicare Part C. They’re privatized Medicare plans, which means your benefits are being managed by the private insurance company that you buy through.
How can Medicare Advantage work for me?
Advantage Plans can work well for you.
However, you will want to make sure the plan meets these three things:
1. The Medicare Advantage plan must be accepted by your current doctors and your future doctors.
The first step in choosing the right Medicare plan is ensuring that the doctors you see now and the ones you want to see in the future accept the plans you’re looking at.
Here’s an example:
When it comes to our clients with certain medical needs, we tend to see that they want to see prominent specialists like the Mayo Clinic and MD Anderson.
You may not know that these big-name research hospitals don’t usually take Medicare Advantage plans.
So my point is this…
If your doctor does not take Medicare Advantage, it is not the right plan for you.
With that said, in a place like Kaiser, who only accept Medicare Advantage, then Medicare Advantage can be an excellent option for you.
2. What medications do you take?
After helping over 100,000 people make their right Medicare decision, I have found that some people with expensive medications can be better off on a Medicare Advantage plan.
This is not always the case, but it’s something that we always consider when our clients have expensive medications.
3. Medicaid
If you’re on Medicaid, then Medicare Advantage could be an excellent option for you.
Disadvantages of Medicare Advantage
My concern with Advantage is the out-of-pocket maximums that jeopardize your retirement savings.
You could be facing out-of-pocket costs anywhere from $7,000 in-network to $10,000 plus out-of-network.
In my experience, I see that people pay the most for Medicare when they’re on Medicare Advantage.
These plans are great when you’re healthy, but the costs begin to add up quickly when you get sick.
These plans always seem great because of perks like:
- “Zero-premium” options
- Free gym memberships
- Extra dental and vision coverage
Choosing a plan based on these three things is the costliest mistake I see people make every single day.
Taking advice from friends and family about their plans and how they work for them is the second biggest mistake I see people make.
Remember:
Due to Medicare insurability rules, the plan you pick in the beginning is likely the plan you’ll have for the rest of your life.
Advantage plans can work for you if it meets the abovementioned criteria.
Don’t fall for the advertisements or advice friends and family give.
Make sure it’s the plan that fits your unique situation because if you don’t, this is a mistake you likely cannot completely reverse.
The Medicare Coach is not an insurance company, agent or broker. We are an independent Medicare expert helping seniors easily make their right Medicare decision.
You can join my FREE Medicare workshop to get unbiased guidance on your best Medicare decision.
