Five things to consider if a Medicare Advantage plan is for you

By STEVE GULAS
Bolte Insurance

Medicare Advantage Prescription Drug Plans, also called Medicare Part C, typically offer a premium saving alternative compared to taking your Medicare Benefits from Original Medicare combined with a Supplemental plan and a separate Part D prescription drug plan. Medicare Advantage plans can be a great value, however they are not for everyone. Here are 5 things to know and consider if a Medicare Advantage Prescription Drug plan is right for you. What plans you can choose from depends on the county you reside in. Most counties in Northwestern Ohio have somewhere between 15 to 25 different plans to choose from.

1. When you enroll in a Medicare Advantage Prescription Drug Plan the company you enroll with becomes your Primary Insurance. Plans that include prescription drug give you all the coverage of Medicare Part A and B as well as the Part D all wrapped up into one plan. The plan does not pay after Medicare, it pays instead of Medicare. The company you choose to enroll with will process and pay all your claims and you will pay the amount you are responsible for as defined in the plans “Summary of Benefits”. In a Medicare Advantage plan you will have one ID card from the Plan you choose and you will not use your Medicare ID Card.

2. Medicare Advantage plans are primarily HMO or PPO style plans. This means you will typically have fewer choices of providers you can go to compared to Original Medicare and a Supplement. It is very important carefully consider the plans provider network and make certain the medical providers that are important to you are in network with the Medicare Advantage Plan your considering.

3. Medicare Advantage Plans are not standardized from one company to another. This makes it more difficult in comparing plans. There can be significant differences in out of pocket costs for Medicare covered services and what providers you can go to from plan to plan. It is important to know and understand what your cost shares may be for Medicare covered services before enrolling. Also be certain to know what the plans Annual Out-of-Pocket Maximum is. This is the worst case scenario of money you could have out of pocket for Medicare Part A and B covered Services. Plan information can be viewed at the www. Medicare.gov website

4. Medicare Advantage plans are Community Rated. This means everyone pays the same premium in the plans coverage territory and pricing is not based upon age. Thus the premium savings for someone switching to an advantage plan that has supplemental coverage now is generally greater for someone whom may be 85 compared to someone whom is 65. This is because most Medicare Supplemental plan premiums are based upon age and get typically get more expensive as you get older.

5. Many Medicare Advantage plans include additional benefits that Original Medicare does not cover such as limited dental or vision coverage and hearing aid benefits. These benefits can help make these plans a good value offering these benefits however these benefits can vary widely from plan to plan.

Today there are more ways than ever to take your Medicare benefits and many people find this process confusing. An Insurance Agent that represents multiple Medicare plans can help you save much time with their knowledge of plans in your area and can help simplify your plan selection process after listening to your needs.

If you would like some help selecting a Medicare plan you can call Steve Gulas or Chuck Devore at Bolte Insurance Agency.