Who Should Consider a Medicare Advantage Plan

understanding medicare advantage plans

Health insurance has obviously been on the minds of everyone in the U.S. over the past few years with the seemingly never-ending debate about Obamacare. Deciding on your health insurance options when you reach the age of 65 can be a pretty daunting task, but it is an important part of your financial planning. Taking the time to sit down and understand the details of the original Medicare will help you determine whether this would be the best health insurance option for your unique medical needs. The government provides various health insurance options for seniors in order to meet their different health needs. But with all the options available how would you know which one will best address your needs as well as your budget?

One of the options given to seniors for health care aside from the original Medicare is the Medicare Advantage Plan. Simply put, a Medicare Advantage Plan offers basically the same benefits of the Parts A and B of your original benefits with an advantage. Recipients of the Medicare Advantage Plan have the option to include additional benefits into their basic plan and tailor it to suit their unique needs. These additional benefits may include prescription drug coverage, dental check-ups, vision care, preventive care, and health and wellness programs. Medicare Advantage Plans are provided by private insurance companies and the guidelines that they implement with these advantage plans are governed and regulated by Medicare to ensure that their recipients are receiving quality health care.

Original Medicare is already a comprehensive health program, but there are certain medical needs that could be addressed best if you have a Medicare Advantage Plan instead. If you are taking prescription drugs, it will benefit you more to enroll in an advantage plan rather than the original Medicare. The original Medicare will not cover prescription drugs unless you pay extra for Part D coverage. Almost all Medicare Advantage Plans already include prescription drug coverage in its basic benefits and there would be no need for you to pay additional for this extra benefit.

If you want a cap or limit on your out of pocket spending, then you should get a Medicare Advantage Plan. Original Medicare does not have a fixed out of pocket expense maximum and you end up paying for your portion of the service as you use them. By contrast, Medicare Advantage Plans have a set limit on your out of pocket expense and the plan will pay for any expense in excess of that limit.

Seniors who are considering enhancing their health coverage with the addition of a private Medigap can also consider getting a Medicare Advantage Plan instead. Instead of adding this supplement and paying extra for the service when you are enrolled in the original Medicare, having a Medicare Advantage Plan will eliminate the need to purchase this additional coverage and will be more cost effective in the long run.

Original Medicare does not cover dental and vision services, assisted living facilities, as well as nursing home care. If you feel that you will need these services regularly then it will be wiser to get a Medicare Advantage Plan. By careful assessment of your medical needs, your budget, and the options available to you, you will be able to determine which Medicare coverage will best answer your needs.