What Are the Advantages and Disadvantages of Medicare Advantage Plans?

Medicare, which is the federal provider of basic health care for those 65 and above, covers hospital, medical, and (in a number of cases) prescription drug insurance. If you have a preference for private health care, there is also Medicare Advantage for you.

What are Medicare Advantage Plans?

Medicare Advantage Plans, also called “Part C” or alternatively “MA” Plans, can be found in private company options. Medicare pays the companies, and they cover the benefits you’re entitled to.

Advantages and Disadvantages of a Medicare Advantage Plan

What are the Advantages of a Medicare Advantage Plan?

First, you have all the benefits of Original Medicare, which is hospital insurance and so forth. After all, it wouldn’t make sense getting a private plan funded by Medicare if that wasn’t the case!

Second, you will often have extra coverage through the private health provider. It can even cover medical concerns involving sight, hearing, dentist appointments, up to wellness programs (fitness, health maintenance). It might even provide your Medicare “Part D,” prescription drug coverage.

Third, the Medicare Advantage Plan often requires only the Medicare Part B (medical services) premium you would have to pay anyway. Given the extra coverage, this is an advantage and brings you more savings than you otherwise would have had. You would only have some co-payment in the event you see a health professional for additional procedures.

Lastly, your choice takes precedence. We assume you’re going for a private health care provider because of the networks and health professionals they can supply. Because the government regulates them, your age, health, and how you sign up should not be a problem.

What are the Disadvantages of a Medicare Advantage Plan?

Like any other health insurance plans, Medicare Advantage Plans have their own share of cons.

First, although you will be able to choose the health care provider and its network, you won’t be able to choose its co-payment or coinsurance add-ons. A thorough review of their structure is needed so you won’t be caught off-guard by an unexpectedly high co-payment. You also can’t be sure the professional network will stay the same from year to year.

Second, as private health insurers, certain forms of care might not be as automatic. To be scheduled for certain covered procedures, more processes might be needed (authorization from primary care doctors, etc.) than you would encounter through Original Medicare. When you have questions, talk to your Medicare agent or health care provider before you go for any procedure or long-term care situation.

Lastly, Medicare Advantage Plans usually save you the most if you are generally healthy and need mostly preventive care. Their extra coverage on dental and eyesight check-ups, and other kinds of check-ups, can help you maintain a degree of health that has as little cash out as possible. This can help you choose which kind of Medicare would be to your general advantage in the long run.

Medicare Advantage Plans: Worth It?

There is no perfect health insurance plan, whether it’s federal, private, or a mix of both. Instead, use what you learn to make an informed choice about what plan will work best for your lifestyle and long-term plans.

James Donaldson

I like to blog about insurance, health and the great outdoors. Memphis born and raised.