Medicare Advantage: What You Need to Know

When you first become eligible to start receiving Medicare benefits, one of the very first – and arguably the most important – decisions that you’re going to need to make is which type of Medicare you should choose:

1. Original Medicare,
2. Medicare Advantage.

According to the latest data, nearly half of all Medicare beneficiaries opted for Medicare Advantage.

But what is Medicare Advantage? How does it work?

To help you make the most informed decision, below, we’ve provided the answers to these and other key questions and facts about Medicare Advantage.

What is Medicare Advantage?

Medicare is comprised of several different parts.

• Part A provides coverage for inpatient care, such as in hospitals, hospices, and skilled nursing facilities, as well as some home health care.
• Part B provides coverage for outpatient care, such as doctor’s appointments and preventative services, as well as durable medical equipment.
• Part A and Part B combined are referred to as Original Medicare.

Beneficiaries of Original Medicare can decide which doctors and medical facilities accept Medicare they would like to use.

You can also purchase Medicare Supplement Insurance (also known as Medigap) to cover the out-of-pocket expenses that Original Medicare doesn’t cover.

• Medicare Part C, also known as Medicare Advantage, is a bundled form of Original Medicare;
• in other words, it includes coverage for both Part A and Part B.

Other benefits may also be included, such as vision and dental, and most Medicare Advantage plans also include Medicare Part D, which provides coverage for prescription drugs.

Most Medicare Advantage plans do not charge a premium, though beneficiaries are responsible for the Part B monthly premiums (unless you opt for a plan that features a Part B give-back benefit, which will cover all or a portion of the premium for Part B).

Medicare Advantage plans work in the same manner as traditional health insurance plans.

You get to choose a private health insurance plan to cover expenses related to Medicare Part A and Medicare Part B.

Most plans offer additional benefits, as well.

There is also a network of healthcare providers that you will have to use in order to have your health-related expenses covered.

Typically, you’ll pay for the health care you require as you receive it via deductibles, coinsurance, and copays.

As per federal law, all Medicare Advantage plans are required to offer the same healthcare services as Original Medicare; inpatient and emergency care, as well as outpatient care.

These plans may offer additional coverage that Medicare Part A and Part B don’t offer, such as:

•         Dental care
•         Vision care
•         Prescription lenses
•         Hearing
•         Prescription drugs
•         And more

The specific type of coverage a Medicare Advantage plan will offer varies and depends on the specific type of plan that you select.

The Advantages of Medicare Advantage

The primary benefit of Medicare Advantage is that these plans offer additional coverage beyond what Original Medicare provides: hearing, dental, vision, etc.

In 2022, beneficiaries of Medicare Advantage received additional benefits in the amount of an estimated $2,000 beyond the amount that Original Medicare provided.

Another benefit of Medicare Advantage is that there is a yearly cap on out-of-pocket expenses, which isn’t the case for Original Medicare.

Once you have reached the max amount, any other services that you receive that are covered by Medicare Part A and Part B will be covered by the insurer, in full, for the remainder of the year.

If you recently turned or will be turning 65 soon and you believe that Medicare Advantage is the right option for you, it’s important to compare quotes before making your final decision.

To receive quotes from the most reputable insurance companies, fill out the form to the right or dial 1-888-891-0229 to speak to an experienced agent.