Medicare Advantage Plans: 7 Must-Know Facts

  1. A Medicare Advantage plan works just like Part A & Part B Medicare plan.


For instance, if the enrollee gets a flu shot covered under Part B Medicare, then he/she can also get it covered by a Medicare Advantage policy.


  1. A number of MA plans offer additional benefits


Part A & Part B Medicare offers a limited coverage in regards to prescription medications, however, most MA plans not only cover prescription medications but also offer further benefits which include routine vision, hearing and dental coverage in addition to fitness benefits.


  1. MA plans are authorized by Medicare itself


The participant is still in Medicare with the Advantage plan, although the benefits you receive would be managed by private insurance agencies. Nonetheless, you’ll have Medicare protections & rights meaning you can also appeal to the coverage you receive.


  1. Each of the MA plans comes with out of the pocket max


As opposed to Traditional Medicare, MA plans come with caps on the amount much you’ll be paying out of your own pocket for the covered medical charges. The federal max for any coverage is set at $6,700 for this year, however, the plan might have a lower max like $3,400. Out of the pocket max reset each year.


  1. You might be paying 2 premiums most times


A few MA plans come with zero premiums. But, most need you to pay a fixed monthly amount to continue the coverage.


Besides, you’ll also be accountable for paying your Part B Medicare premium to the federal government.


  1. Majority of the health issues won’t stop you from getting MA plans


People with pre-existing disorders, like cancer or high blood pressure, can easily get enrolled in a MA plan.


The lone disorder which may stop you from getting the Advantage coverage is ESRD ( end-stage renal disorder). But, they have the option to participate in Special Needs Coverage. This is also a type of MA plan.


  1. You are able to easily swap your MA plans if you aren’t happy with the current one


You have the ability to switch to a new MA plan anytime throughout the IEP (also known as Initial Enrollment Period) – a seven month period that begins three months prior to your 65th birthday or when you complete 25 months of your disability benefits. This includes that particular month & stretches 3 months after it.


You will be able to switch MA coverage during the OEP (open enrollment period) of your Medicare coverage. This begins on Oct 15 and ends on Dec 7 each year.