Shayna and Kasey are here to discuss everything you need to know about Medicare Advantage Plans!
Shayna: We're with Elite Insurance Partners and MedicareFAQ.com, and today we're here to talk to you all about Medicare Advantage plans… including what they are, who they're good for and what are the pros and cons of these plans are.
Shayna: So, to take it from the very top, what is a Medicare Advantage plan, Kasey?
Kasey: A Medicare Advantage plan is also known as Medicare Part C, it's offered by private insurance carriers and it's an alternative to a Medicare Supplement.
Shayna: And what type of person would benefit from a Medicare Advantage plan?
Kasey: Generally, Medicare Advantage plans are good for people who are healthy, because they don't have as many doctor visits and co-pays for specialists and it's also beneficial for someone who can't afford a Medigap policy because, in reality, some insurance is better than no insurance.
These plans, you must have your Part A and B active in order to qualify to enroll. There is one health question, do you have end-stage renal disease. Now, if you do have end-stage renal disease, the standard Medicare Advantage plans won't be available. However, in some areas, there's what's called a Special Needs Plan.
Kasey: Your Medicare Advantage plan will have a card for you, so when you go to your doctor, you will show your Medicare Advantage card instead of your Medicare card. This is because that private insurance carrier is now gonna handle your claims.
Shayna: And isn't there a way that you can kind of bundle more services into your Medicare Advantage plan?
Kasey: Some of these plans include routine dental, vision, hearing and even gym memberships. It's important to remember that some of those services are only routine. So if you need dentures, fillings, root canals, you may want to purchase a separate, standalone policy.
Shayna: Now, also with Medicare Advantage plans, you will have a one year trial right through your Guaranteed Issue, meaning that you will have 12 months to have your Medicare Advantage plan and within that time, you can either choose to stick with it or switch to a Medigap policy instead. You will also be protected if your Medicare Advantage plan leaves your service area through Guaranteed Issue, and you'll be able to switch at that point as well. Now, let's get a bit more into the nitty-gritty. What are some of the specific pros and cons of these plans?
Kasey: Well, the biggest pro that none of us can ignore is the zero dollar premium. And I know some of the plans do just have a lower premium, I've seen them between $20, all the way up to $100 bucks, depending on where you live. The downside to having a low premium is that you end up with higher out of pocket costs. The way you gotta look at it is either you're gonna pay for it upfront or you're gonna pay for it later.
Shayna: Another thing to think about is when you have a Medicare Advantage plan, you have a more restricted network. As were with the Medigap policy, you can go anywhere where Medicare is accepted. That's not the case for Medicare advantage plans. Additionally, in most cases, referrals are needed to see specialists. So you will have to go to your primary care doctor, pay that copay to then go to the specialist and pay that copay. So all are very important things to think about when you're planning your year ahead.
Kasey: And if you throw in a hospital visit, a lot of them are $100 to $300 a day for the first 4 to 6 days.
Shayna: One pro is that your Medicare Advantage premium can be deducted right from your social security, so it is one less bill you have to worry about manually paying.
Kasey: Another pro is there's national emergency coverage, so if you travel frequently and you have an emergency situation, you do have coverage with your Medicare Advantage plan, however, if you leave the country and have an emergency, you pay for that out of your own pocket.
Shayna: So as you can see, there are a lot of pros to Medicare Advantage plans and there are a lot of cons that you would have to factor in. If you're someone who's confident with your health, who doesn't really frequent the doctors often, this might be a great plan for you. Now, if you have any questions about Medicare Advantage plans, Kasey and I are gonna be eagerly waiting to answer them. We'll see you next time!
Want more information on the topics covered? Here are some additional helpful resources:
Medicare Advantage vs Medicare Supplements:
Best Medicare Advantage Plans for 2020:
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