What is Medicare Advantage?

Medicare Advantage

Medicare Advantage (Medicare Part C) plans are Medicare plans, sold by private insurance companies, that combine original Medicare (Medicare Part A and Medicare Part B) coverage and additional benefits. Average 2021 premiums for Compare Medicare Advantage Plans are expected to decline 34.2 percent from 2017 while plan choice, benefits, and enrollment continue to increase. The Medicare Advantage average monthly premium will be the lowest in 14 years (since 2007). This is for the over 26 million Medicare beneficiaries projected to enroll in a Medicare Advantage plan for 2021. In some states, including Alabama, Nevada, Michigan, and Kentucky, beneficiaries will see average premium decreases of more than 50 percent since 2017.

Beneficiaries will have more plan choices in Medicare Advantage, with about 2,100 more Medicare Advantage plans operating in 2021 than in 2017, a 76.6 percent increase. Overall, beneficiaries will be able to choose from more than 4,800 Medicare Advantage plans during Medicare Open Enrollment.

CMS has added a new “Insulin Savings” filter on Medicare Plan Finder to display plans that will offer the capped out-of-pocket costs for insulin. Beneficiaries use the Medicare Plan Finder to view plan options and look for a participating plan in their area that covers their insulin at no more than a $35 monthly copay.

Medicare Open Enrollment begins on October 15, 2020, and ends on December 7, 2020. During this time, Medicare beneficiaries can compare coverage options like Original Medicare and Medicare Advantage and choose health and drug plans for 2021. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices and decide on the options that best meet their health needs.

 Most Medicare Advantage plans offer the following benefits:

  • hospitalization
  • some home healthcare services
  • hospice care
  • doctor visits
  • prescription drug coverage
  • preventive care
  • dental
  • vision
  • hearing
  • SilverSneakers fitness memberships

There are different types of Medicare Advantage plans to choose from, including:

  • Health Maintenance Organization (HMO). HMO plans utilize in-network doctors and require referrals for specialists.
  • Preferred Provider Organization (PPO). PPO plans charge different rates based on in-network or out-of-network services.
  • Private Fee-for-Service (PFFS). PFFS plans are special payment plans that offer provider flexibility.
  • Special Needs Plans (SNP). SNPs help with long-term medical costs for chronic conditions.
  • Medical Savings Account (MSA). MSA plans are medical savings accounts paired with high deductible health plans.

What are the advantages of Medicare Advantage?

Compared to original Medicare, there may be advantages if you choose a Medicare Advantage plan.

Convenient coverage options

Original Medicare only offers two types of coverage: hospital insurance and medical insurance. If you want additional coverage, you’ll need to purchase Medicare Part D for prescription drug coverage and Medigap for supplemental coverage.

With a Medicare Advantage plan, all your coverage options are in one convenient plan.

Personalized plan structures

Medicare Advantage offers different plan types for your personal situation. For example, if you have a chronic health condition, an SNP Advantage plan can help with your medical costs. If you prefer provider freedom, a PPO or PFFS plan may be more of what you’re looking for. If you want extra services like dental, vision, or hearing, many Advantage plans include them.

Cost-saving opportunities

Many Advantage plans have no premiums and offer low or no deductibles. Another advantage of choosing Medicare Advantage is that most plans set limits on the maximum out-of-pocket costs you may pay.

Also, research Trusted Source has shown that you may save money on laboratory services and medical equipment by switching to a Medicare Advantage plan. If you choose a Medicare HMO plan, you may have even more savings on healthcare services provided by your HMO network.

Coordinated medical care

Many Medicare Advantage plans include coordinated medical care. This means that your healthcare providers actively communicate to coordinate your care between different types of healthcare services and medical specialties. This ensures you have a healthcare team and helps avoid unnecessary expense, testing and helps avoid things like medication interactions.

In one study Trusted Source, researchers found that coordinated care was associated with higher patient ratings and more positive staff experiences.

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About the Author: Amanda Byers

Amanda Byers is a graduate of Columbia, where she played volleyball and annoyed a lot of professors. Now as Zubuz’s entertainment and Lifestyle Editor, she enjoys writing about delicious BBQ, outrageous style trends and all things Buzz worthy.