What Is a Medicare Advantage Plan?

Medicare Advantage is essentially a bundled alternative to traditional Medicare, also known as Original Medicare. This plan is offered by private insurance companies that contract with the federal government to provide health insurance coverage to those who qualify for Medicare. Read on to know more about Medicare Advantage.

Pros and Cons of Medicare Advantage

Medicare Advantage plans have certain benefits and drawbacks. While they’re the go-to option for some people, they’re, unfortunately, not right for everyone.

Pros:

Additional benefits, like subsidies or cost savings toward dental, hearing, vision, etc., are included.

There are limits on out-of-pocket expenses for medical or hospital coverage. The limits are determined by the Centers for Medicare & Medicaid Services.

The premiums are lower than traditional Medicare.

Cons:

There are limits on one’s ability to switch back to Original Medicare.

Medicare Advantage offers less freedom to choose medical providers.

The plan requires beneficiaries to reside and get their non-emergency medicare care in the specified geographic service area.

How do Medicare Advantage plans work?

Medicare Advantage plans, also called Medicare Part C, provide the same benefits as Medicare Part A, which offers coverage for hospitalizations, and Medicare Part B, which covers doctor’s visits. Medicare Advantage plans also offer prescription drug coverage, which is offered by Medicare Part D. In addition, Medicare Advantage may also cover the costs of hearing aids, glasses, eye exams, and dental care, either partially or in full. These plans, unlike Original Medicare, are offered by private insurance companies.

How Does Medicare Advantage Differ from Original Medicare?

Medicare Advantage plans have provider networks that limit one’s choices. People who go outside the network may have to pay significantly more. On the other hand, with Original Medicare, one can use pretty much any medical facility or doctor that accepts Medicare.

However, in the case of Medicare Advantage, while people have less freedom, they can benefit from lower premiums compared to Original Medicare.

Before choosing between Medicare Advantage and Original Medicare, it is important to understand what each type of plan offers and choose whatever is most suitable.