Top 3 Reasons to Enroll in a Medicare Advantage Plan

By: Mark Mabaquiao

 

When I meet with potential clients, they usually fall into two camps. They either have never heard of Medicare Advantage (MA) or they think an MA plan is a Medicare Supplement plan or vice versa. To help clear this up, I’d like to briefly describe what an MA plan is and go over the top reasons why it might be a good fit for a Medicare beneficiary.

An MA plan works very similarly to an employer group health plan. For example, like a group plan, it can be in the form of an HMO or PPO. Like a group plan, it may or may not have a monthly premium. Many MA plans have a $0 deductible so benefits begin immediately. Plans may include drug coverage, gym membership, transportation, an over-the-counter benefit, 24-hour nurse line, outof- network emergency and urgent care coverage, and basic dental, vision, and hearing at no additional cost. When you need medical service, you pay a copay or coinsurance until you reach a specific dollar amount, called the maximum out-of-pocket. Medical expenses that exceed the maximum out-of-pocket are generally covered 100% by the insurance carrier.

The top 3 reasons to consider an MA plan are:

1. Most, if not all your medical providers are in-network: No one ever wants to lose the ability to see the doctor they’ve been going to for decades. It can be a special bond and many doctors are in-network for multiple MA plans.

2. Your out-of-pocket drug costs are competitively low: Many MA plans have lower to no monthly premiums compared to stand-alone drug plans. They can also have lower copays and coinsurance depending on the prescribed drug.

3. Saving hundreds, if not thousands of dollars in monthly premiums and/or medical costs: Saving money, especially those on fixed incomes, is important. Many people fall for scare tactics and biased opinions. In the Medicare world, the more you pay for something, doesn’t necessarily mean better quality.##