The #1 reason people regret their Medicare decision is because they picked the wrong Medicare program.
When you join Medicare there are two programs to decide between: Medicare Advantage and Original Medicare
These programs are similar in many ways but are very different in others.
The way the insurance companies and brokers are selling these products is leading people to make an uninformed decision that ends up costing them lots of money in the future.
In today’s blog I will focus on Medicare Advantage, so you can better understand the program to decide if it’s for you.
More and more people join Medicare Advantage plans every year, but there are many pros and cons to these plans that most people aren’t aware of.
Let’s explore the top 3 positives and negatives of Medicare Advantage plans.
Medicare Advantage Advantages
1: Your health care benefits are usually packaged into one plan.
Most Medicare Advantage plans include your hospital insurance (Part A), doctors insurance (Part B), and prescription coverage into one plan. In addition, Medicare Advantage plans have their own co-pays, deductibles and max out-of-pocket expenses. so you
2: Dental Vision Hearing Gym
As most people know, Medicare only covers medically necessary health care when it comes to dental, vision, and hearing. Many Medicare Advantage plans include coverage for these services at an extra price. They to cover items such as hearing aids, glasses, and dental fillings.
3: Lack of Insurability Rules
Unlike Medicare Supplement plans, you can join a Medicare Advantage plan without proving you are healthy. After your 6-month window, supplement plans can ask you about your health and pre-existing conditions. Based on your situation they can charge you more or refuse to provide coverage. Medicare Advantage cannot do the same. The general Medicare Advantage plans are required to cover you.
Medicare Advantage Dis-Advantages
1: Network limitations
Medicare Advantage plans primarily act like HMOs or PPOs. Unlike Original Medicare where you can see any doctor that accepts Medicare assignment, with an Advantage plan you are usually required to only see doctors inside of the programs network. It is crucial that you understand what doctors you can see in a Medicare Advantage plan. We especially see this become a problem when people(participants) get cancer and want to go to Mayo Clinic or MD Anderson for care. These facilities accept a very small number of Medicare Advantage plans, so if your plan isn’t accepting (hasn’t accepted) you, most likely won’t be able to get care.
2: More changes in Medicare Advantage plans each year
Because of how Medicare Advantage plans are regulated, we see more changes in these plans that affect the Medicare beneficiary. In particular, in certain regions we see doctors dropping Medicare Advantage plans and Medicare Advantage plans dropping doctors. This can be very frustrating to patients because once the relationship ends between the insurance company and the doctor, you will need to get a new doctor that is covered by your insurance.
3: High maximum out-of-pocket on many plans
Many Medicare Advantage plans have a maximum out-of-pocket of $6,700. If you get sick and hit this amount it can start to quickly drain your savings. Depending on your health situation this may or may not be an issue, but it’s important to understand where the maximum out-of-pocket is for each plan.
As you can see there are many things to take into consideration when making your decision.
If you are making your Medicare decision, I encourage you to join our free online Medicare workshops called “How To Make Your Best Medicare Decision Without Wasting Time On Research or Paperwork”. In this workshop I will share 5 steps to follow to easily make your right Medicare decision.
