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Are Medicare Advantage Plans really a boon? Find out

Consider a situation where you come across a health plan and you go, “Man it’s too good to be true!!” Though speaking of other plans is a tad too difficult, that is definitely not the case with Medicare Advantage plans. You must have heard innumerable ‘positive’ stories about these plans but ask people who have used them and you’ll know they seem to be more feel- good than they really are. Medicare Advantage plans often come to be compared with Medicare Supplement coverage and the former, more often than not, is touted to be better. The truth, though, is different with Supplemental plans winning in ways of benefits, hands down. Seen objectively Medicare Supplement plans are far more comprehensive than Advantage plans. Here’s why-

Medicare Advantage Plan? What’s that? – In order to analyze the intricacies of a Medicare Advantage plan one should have a clear idea of what it is all about. An Advantage plan offers benefits that you’ll find on the original Medicare plan, the only difference is that the former is provided by a private insurer. In this case what happens is the insurance company in question gets into an agreement with Medicare to be able to offer the benefits. A peculiarity about Medicare Advantage plans is that they don’t let you enroll until you have dropped out from Medicare. Getting into a plan of this nature can be worrisome since you do not have the guarantee that it will renew its contract with Medicare annually.

Opting for a Medicare Advantage plan can turn out to be a bit tricky if you do not know what the insurance agent may be hiding from you. First of all, do not think nothing comes off the agreement that the insurance company offering the Advantage plan strikes with Medicare. Not only that, the insurance company also charges you a certain sum as premium. No matter how much insurance companies scream their lungs out that the premiums you pay are really low, never believe them completely. The fact is that these plans not only charge a lower premium but also offer a fewer number of benefits. In these lines, a Supplement plan is far better since it requires you to pay an affordable premium and also enjoy a host of comprehensive benefits.

A startling fact about Medicare Advantage plans is that they leave several gaps in coverage. Yes, under an Advantage plan, you often have to make co- payments for doctor visits, emergency care and skilled nursing. This stands stark in contrast to Supplement plans that cover most services you’d want to avail. Apart from that, the way people believe in Advantage plans at the drop of a hat is quite frightening. What you can’t afford to forget is that these plans give you access to your Medicare benefits either through a Fee for Service, Health Maintenance Organization or a Preferred Provider Organization plan. And mind you, these plans have their own set of problems. Under a Fee for Service system, many doctors won’t agree to go through the process since payments get delayed and overall the procedure is long. As for an HMO, the plan would often restrict you to its own network. Though the situation is a lot better with PPO plans, you still have to pay high co- insurance if you happen to step outside the company’s provider network.


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