If you are like most people, you have probably noticed a barrage of Medicare Advantage TV Commercials. These commercials feature celebrities from both TV and sports. This may have prompted you ask yourself WHY?!!! Many of the ads are down right annoying or at least confusing to most people.
The ads tell you about how you can get a free Medicare Advantage plan that provides all the benefits you are entitled to such as; dental, vison and hearing as well as rides to your doctor’s office. It all sounds fantastic and makes many people currently on Original Medicare question if they have made the right choice when they chose their coverage. This is the case especially if they are paying for a Medicare Supplement and Part D prescription drug plan. Who wants to be paying for Medicare coverage when you can get all these great benefits for free?
The number of people who choose Medicare Advantage plans (or Medicare Part C) is growing by the day. In 2022 Medicare Advantage plan enrollments went up approximately 3%. This means; that about 28 Million people enrolled in MA plans this year (over 40% of Medicare beneficiaries). These numbers show that all these TV Commercials are really registering with Medicare enrollees who appreciate the value these plans are providing for them.
Medicare Advantage plans are offered by private insurance companies. Beneficiaries use MA plans in place of Original Medicare which is provided by the federal government. If you listen to the commercials, the MA plans sound like a great way to get needed coverage as well as so many value added benefits without the added expense of a Medicare Supplement and Part D prescription drug plan. What could sound better than that to someone who may be on a fixed income?
The commercials really push the word “FREE”. This can be somewhat deceiving if the potential client does not understand fully what they are signing up for. Many plans boast $0 premiums as well as $0 co-pays and $0 deductibles. Unfortunately, that is not the whole picture.
These plans require enrollees to use providers that are in the plans network in order to have the no or low co-pays for care. If you go outside of the plans network for care, you may receive a rather sizable bill.
Medicare Advantage enrollees may end up with annual out of pocket costs as high as $7,500 for in-network services. If they opt for out-of-network care their annual costs could be as much as $11,000.
If you ask anyone who is getting ready to sign up for Medicare, I’m sure 9 out of 10 people will tell you it is a either confusing or overwhelming. There are many moving parts to this enrollment and without proper research or guidance, enrollees can make some very costly mistakes. In many instances, your free plan will have a co-pay for specialists, hospitals and in many other instances. Because these are managed care plans, there may also be limited number of days per year provided for things like physical therapy.
The bottom line; these plans are a great money saver if you are a healthy person. They do provide many great free benefits that are not part of Medicare Supplement plans. Most of the available MA plans also include credible prescription drug coverage at no extra cost. That is a very important option to have.
When you are trying to navigate the sea of MA plans, the best advice I can give is to find a reputable Medicare agent who can go over all the fine points of the plans available in your area and make sure that your doctors and medications are covered by whichever plan you decide to enroll in.
Although the TV Commercials are tempting, you should be very careful before you switch your current plan over. If you used an agent to help you choose your current plan, it is a good idea to give them a call and ask for their guidance so you don’t get yourself into something you will regret.
Please note; If you are in original Medicare and a Medicare Supplement plan, you can go to any doctor that accepts Medicare assignment. MA plans do not give you that luxury. You must stay in-network to avoid a costly doctor’s visit. Please double check any MA plan you are considering and be sure that they cover your medications and also that your doctor participates with the plan.
There are a couple times a year when you can switch from one MA plan to another.
The first is the annual Open Enrollment Period. This takes place each year from October 15 through December 7th. Medicare enrollees have the opportunity to change from Original Medicare and a PDP plan to an MA plan or from an MAPD to Original Medicare and a PDP plan. You can also switch from one MA plan to another or switch from one PDP plan to another. it is always a good idea to check your coverage at this time of year and make sure you are getting the benefits that you need.
The second opportunity to switch is the Medicare Advantage Open Enrollment period. This enrollment period runs from January 1st through March 31st each year. During this time, you can change from one MA plan to another or switch back to Original Medicare and a Part D plan.
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