Medicare Advantage Plans |
Did you know that We have an interactive Facebook group for Medicare beneficiaries with over 50,000 members as of June 2023? My team answers your Medicare questions there 365 days a year. Last week, while I was doing my nightly scroll through the various posts, I found once again that one of our most popular topics of conversation is surrounding Medicare Advantage plans. I've noticed that some of our newest group members want to know what others with Medicare Advantage plans like about their plans and why Medicare Advantage plans are becoming more popular every year. So, we wanted to share some of their answers with you.
Why Do People Like Medicare Advantage Plans?
Let's take a look at some of the most recent comments on a post in our Facebook group. One group member shares that her husband has a Medicare Advantage plan, and over eight years with several health issues requiring diagnostic imaging and various medical procedures, he has never experienced any delays in coverage or denials. She goes on to say that his expenses over that time frame were less than $1,000, and he saved on Medigap premiums all that time. Meanwhile, she is paying $2,500 per year for her Medigap plan, which is what her doctor accepts, but she wishes he participated in the Advantage plan network so she could choose that plan instead.
This particular post brings me back to a point that I've made many times over the years while filming videos like this one for Medicare beneficiaries: what are the risks? Yes, there is some risk of unexpected spending on a Medicare Advantage plan if you encounter a costly health condition. However, if you are the kind of person who will take the money that you would have spent on a Medigap plan and put that into a savings account solely for future medical emergencies, then you're not likely to panic when some of those emergencies occur. Overall, you might be quite happy with an Advantage plan as long as it has your doctor in the network and your important medications on the plan's formulary.
In a future year, if new or more expensive health conditions appear, you've got that money set aside for those extra medical services. Look at the plan's out-of-pocket limit for Part A and B expenses and save at least that much so that in the worst-case scenario, you are still good to go financially.
What About Denied Claims?
Although some Medicare beneficiaries are wary of Medicare Advantage plans due to the possibility of having denied claims or procedures, this particular example shows that that is just not always the case. Here's another comment where the client says that his out-of-pocket maximum limit on his Medicare Advantage plan is $3,000 per year, and that is all he had to pay even though he had a double lung transplant.
We know that Medicare Advantage plans can set their maximum out-of-pocket limits as high as $8,300 in-network and $10,000 or more out-of-network in 2023, but in most areas, you can find plans with much lower maximum out-of-pocket limits, like $3,000 or $5,000. Each plan has a different maximum out-of-pocket limit, so we encourage you to review all of your options.
Another reason that some people stated they love their Medicare Advantage plan is related to some of the extras or value adds that were built into their plan. This commenter enjoys the extra benefits that are included in her particular Advantage plan, such as dental, vision, and hearing benefits, a gym membership, and a quarterly allowance that she can spend on over-the-counter products. This is a very popular perk of Medicare Advantage plans, and over the last decade, it seems like they have gotten richer, as now plans can even include supplemental home health benefits such as home modifications, bathroom grab bars, and the like.
As the years go on, based on the history of the improvements we've already seen, we can expect these benefits may continue to increase. It's important to shop around, as the extras will vary by plan, and remember you should always choose a plan based on how well it covers your medical needs and consider the extras a bonus.
Common Misconceptions
Another common misconception is that none of your doctors will be in the plan's network or that somehow your providers will not be paid. Here's what one of our Facebook group members had to say about that. As always, you should make sure that your important providers are in the plan's network and your medications are on the drug formulary within the policy before you join the plan.
Watch our other videos on Medicare Part C to learn more about how important that is. We also have many folks who say that they compared the two different options—Medicare Advantage versus Original Medicare and Medigap—and they chose to go with a Medigap plan, which is also perfectly fine. Our agents are here to educate you on both options so that you can choose what you feel is best for you, and then we support you on the back end of that policy.
I wanted to throw this last comment in here just because having one ID card is a feature that many people appreciate about Medicare Advantage plans. Instead of having a Medicare ID card, a Medigap ID card, a Part D card, and possibly even a dental, vision, and hearing plan ID card—all with their own separate premiums each month—a Medicare Advantage plan that includes Part D offers people the convenience of having just one card and one payment, sometimes even a zero premium, which means you don't pay anything for the plan itself beyond what you already spend on Medicare Part B.
Now, just because your friend or neighbour loves their Medicare Advantage plan, this does not necessarily mean that it will be the right one for you. We encourage you to review both your options of Medicare supplements (Medigap) and Medicare Advantage plans to find what would be the most cost-effective fit for you. Remember too that Medicare Advantage plans, like Part D drug plans, have changes to their benefits from year to year. This means you need to sit down each September to review the plan's annual notice of change and make sure that it will still be a good fit for you in the year ahead.