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Why Medicare Advantage? Who is it good for?

Medicare Advantage

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As soon as you start understanding Medicare, you start hearing about MedSupps, MediGap plans, and Medicare Advantage. What are they, and how do you decide which one is best for you?

What is a MedSupp?

A Med Supp, or Medicare Supplement, is the same thing as a MediGap plan. MediGap is actually just a nickname for Med Supps. And we have to say Med Supp because it’s shorter, and sounds cooler, and there are way too many syllables in insurance terminology.

MedSupps are plans F through N. They’re called MediGap because they plug holes in original Medicare. A lot of people ask “What DOESN’T original Medicare cover?” It turns out, Medicare Parts A and B don’t cover a LOT of things that many people assume they do. And that includes vision, dental, hearing, and long term care, just to name a few.

Now, the thing about a MedSupp that leads a lot of people to choose Medicare Advantage instead is the price. Generally speaking, MedSupps have higher premiums (monthly fees) than Medicare Advantage plans.

What is Medicare Advantage?

Medicare Advantage (part C) provides at least as much coverage as original/traditional Medicare (parts A and B), and sometimes adds in the prescription drug coverage you’d need a Part D for otherwise. In this case, it’s called an MAPD. The PD means prescription drugs. You can get Medicare Advantage only, or an MAPD, which includes prescription drug coverage.

As you now can see, in insurance and Medicare, there are at least two words for everything, just so that everyone is more confused. I’m not sure why that’s the goal, but it’s working!

What’s Good about Medicare Advantage?

There are several attractive benefits of Med Advantage plans you might like:

  • The out-of-pocket maximum is as high as $7,550 a year.
  • Many plans cost $0 a month.
  • Usually includes drug coverage.
  • Many include hearing and dental.
  • Can include gym discounts.

If the most important thing to you is the monthly premium amount, you may be attracted to this. But remember that when you do need care, it may be more expensive.

It’s difficult to generalize about Med Advantage because the plans are different in each state and count. Work with a broker who can help you find local plans and walk you through the decision.

What’s Bad about Medicare Advantage?

There are downsides to Med Advantage too, and some of these may make a big difference to you.

  • Can only switch during Open Enrollment. If you choose a plan during AEP (Oct 15 – Nov 7), you have to wait til Jan 1st to change it. The Open Enrollment Period (OEP) is Jan 1 – Mar 31 each year.
  • Plans are difficult to compare since no two MA plans are alike. This is the opposite of the MedSupp plans’s standardization.
  • Usually no nationwide coverage, so not so great if you travel a lot or spend a lot of time in another state.
  • These are mostly HMO plans that require referrals to see specialist.
  • Plan can change drug and medical coverage each year.

If money is not as much of an issue for you, or you prefer consistent and predictable healthcare costs, a MedSupp might be better. Also, if you are a snowbird or something similar, where you have two houses in different states, you might prefer a MedSupp.

As with anything in Medicare, it’s best to have a broker you trust. We recommend you find one, like those at PandaCare, and get their help!

Medicare Advantage FAQ

A Med Supp, or Medicare Supplement, is the same thing as a MediGap plan. MediGap is actually just a nickname for Med Supps.

MedSupps are plans F through N. They’re called MediGap because they plug holes in original Medicare.

Generally speaking, MedSupps have higher premiums (monthly fees) than Medicare Advantage plans.

Medicare Advantage (part C) provides at least as much coverage as original/traditional Medicare (parts A and B), and sometimes adds in the prescription drug coverage you’d need a Part D for otherwise. In this case, it’s called an MAPD. The PD means prescription drugs. You can get Medicare Advantage only, or an MAPD, which includes prescription drug coverage.

There are several attractive benefits of Med Advantage plans:

• The out-of-pocket maximum is as high as $7,550 a year.
• Many plans cost $0 a month.
• Usually includes drug coverage.
• Many include hearing and dental.
• Can include gym discounts.

The monthly cost is attractive, but remember that when you do need care, it may be more expensive.

It’s difficult to generalize about Med Advantage because the plans are different in each state and count.

• Can only switch during Open Enrollment. If you choose a plan during AEP (Oct 15 – Nov 7), you have to wait til Jan 1st to change it. The Open Enrollment Period (OEP) is Jan 1 – Mar 31 each year.
• Plans are difficult to compare since no two MA plans are alike. This is the opposite of the MedSupp plans’s standardization.
• Usually no nationwide coverage, so not so great if you travel a lot or spend a lot of time in another state.
These are mostly HMO plans that require referrals to see specialist.
• Plan can change drug and medical coverage each year.

If money is not as much of an issue for you, or you prefer consistent and predictable healthcare costs, a MedSupp might be better. Also, if you are a snowbird or something similar, where you have two houses in different states, you might prefer a MedSupp.

As with anything in Medicare, it’s best to have a broker you trust. We recommend you find one, like those at PandaCare, and get their help!

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