Deciding on Medicare advantage may be tricky. Often people find themselves failing to choose which the best Medicare Advantage plan is for them.
It is a type of health insurance that is provided by private companies approved by Medicare, based on monthly fees per enrollee, rather than billing for each medical service provided. This is also referred as part C or MA plans and it includes all those services you get in Part A and B Medicare.
What to consider before applying?
Before you take a Medicare Advantage plan, you must consider the following;
- Is there a need of drugs prescription?
If you take prescription drugs, Advantage plan may be the best option for you since Medicare A and B parts do not include prescription medications.
- Is there a need of vision, hearing, dental or wellness plan services?
If someone needs specialized care, often having eye or dental problems, there is a need Medicare advantage, since Part A and B does not offer extra services.
- Do you want a cap on out-of-pocket payments?
Part A and B do not cover out-of-pocket payments (OOP). These are direct payments made by an individual to health care providers at the time of service use excluding prepayment for health services.
- Are you satisfied with your Medigap options?
Medigap helps with many of your Original Medicare deductibles and other expenses. With Medigap plans you have freedom of choice, it means that there is no networks, no referrals, and nor service area restrictions.
- Which of the two do you prefer between a copay and coinsurance?
Normally Part A and B Medicare charge a 20 percent coinsurance for most service. Advantage plan allow to beneficiary having both HMOs and PPOs. This means that an individual can seek health services within and outside the plan’s network.
Cost of it
The cost depends on the plan and each plan considers a number of factors as covered below:
- Does it include a monthly premium?
- Does it pay your monthly Part B premium?
- Does it have a yearly deductible or any addition deductable
- How much does it cost for copayment or coinsurance?
- What type of health care is needed?
- Is visiting the doctor or supplier who accepts assignment is necessary?
- Does the following of rules is necessary, such as using network providers?
- Is there any extra benefits and does the plan charge of it?
- What is plan’s yearly limit on your out-of-pocket costs for all medical services?