The Medicare Advantage is the second route you can take on Medicare. While it has networks, it provides beneficiaries with a much lower monthly premium and a lot of extra benefits.
When you choose a Part C Medicare Advantage plan, you are transferring your Medicare coverage from the government to a private insurance company.
Medicare Advantage Plans are much lower in cost, sometimes having a $0 monthly premium, and also include drug coverage. This means there is no need to buy a Part D plan.
While Part C plans have networks, for many people, Part C coverage mirrors the networks they have been using for their group insurance.
Pros of Medicare Advantage
Low or no monthly premiums
Many areas have $0 monthly premium Medicare Advantage Plans available. If there is not a $0 plan, there will be a plan with a very low monthly premium.
Drug Plan included
Most Medicare Advantage plans include drug coverage, which you have to pay for separately if you have a Medicare Supplement. This means you do not have to pay for this part of your coverage separately.
Along with drug coverage, many Medicare Advantage plans also include coverage for dental, hearing, and vision, something Medicare Supplements don’t include. Many Advantage plans also include benefits that cover gym memberships or car rides to doctor’s appointments. While the benefits offered are going to vary by the plan you choose, these extra benefits can be nice.
Cons of Medicare Advantage
Medicare Advantage plans require members to stay within a network of certain doctors and hospitals. If you go out of network, you’ll likely have to pay more out of pocket than you would’ve otherwise and could even incur the full cost of medical services provided to you. To avoid a huge medical bill, you’ll have to be sure you’re in network every time you visit a doctor.
Does not travel well
Because of the network restrictions, Advantage Plans don’t travel well. If you frequently visit family or friends in other locations or travel a lot, you might not want to sign up for a Medicare Advantage plan.
Advantage plans are based on your zip code. This means you could have very limited choices of Advantage plans, or even no Advantage plans, offered in your area.
Copays, coinsurance, and deductibles
Medicare Advantage plans still require that you pay copays, coinsurance, and deductibles when you use services. If you visit the doctor frequently, you might want to compare your options to see what might be more affordable in the long run.
Advantage plans can only be switched during Annual Enrollment
Medicare Advantage plans can only be switched during the Medicare Annual Enrollment Period from October 15th – December 7th every year. This means if you purchase a policy and don’t like it, you’ll have to wait a year until you can get out of it. Medicare Supplements, on the other hand, can be changed at any time of year. (If you qualify for a Special Enrollment Period, this restriction does not apply.)