When it comes to Medicare Advantage Plans, it's important to consider your location, health care needs, budget, and preferences. While these plans can be expensive if you're sick due to uncovered copays, they can also offer a range of benefits such as dental, vision, hearing, and wellness programs. A Medicare Advantage plan may also provide more preventive care than traditional Medicare, according to a JAMA study. A zero-premium Medicare Advantage plan may seem too good to be true, but it does exist.
These plans replace Original Medicare completely and are designed to help limit out-of-pocket expenses. However, they are not standardized and benefits can vary widely. Private companies offer Medicare Advantage (Medicare Part C) and Medicare pays them to bear their medical risks and costs. This allows them to transfer cost-saving benefits to you in the form of lower monthly premiums.
It's important to note that even with a Medicare Advantage plan, you will still need Part D prescription drug coverage. Additionally, many doctors don't like these plans because they put patients' financial risk in the doctor's hands. To help pay for things that Medicare doesn't cover, you can choose to buy supplemental insurance known as Medigap (or Medicare Supplement Insurance). If you have a limited budget and can't pay the monthly premiums of a Medicare supplement plan, then a Medicare Advantage plan with sufficient coverage for your health needs is a good deal.
However, networks are restrictive so you'll need to make sure your preferred doctors are in network before choosing a plan. For those who live in rural areas, where there are fewer doctors and hospitals, the Advantage plan's tight networks can be an obstacle to getting the care they need. In the end, it's up to you to decide if a Medicare Advantage plan is right for you and your budget. Keep in mind that with Original Medicare and Medigap plans, you will still need Part D prescription drug coverage and that most beneficiaries will only receive a Medicare Supplemental Open Enrollment Period once in their lifetime.