For the average individual, Medicare can be confusing, overwhelming, and difficult to understand. Once you throw in the word “advantage,” the game changes, but it remains equally confusing, overwhelming, and difficult to understand!
If you’re currently trying to figure all this out and wondering to yourself “What’s Medicare Advantage?” “How does it work?” and “How does it differ from Medicare itself?” then you’re definitely not alone.
But, here’s the good news: while it can seem like a lot of information and appear difficult to understand, it’s not difficult to find the answers you want and the help you need. In fact, we’ve gone ahead a laid out a few answers to common questions for you!
What’s the Difference Between Medicare & Medicare Advantage
Medicare Advantage became a common term after the 2004 Medicare Modernization Act, but it’s been around since the 1980s.
While Medicare has many parts – A for Hospital Insurance, B for Medical Insurance, and D for Prescription Drug Coverage – the “advantage” to Medicare Advantage Plans is that they offer bundled plans that combine parts A, B, and even D for maximum coverage and ease. These plans are typically offered by a private company that contracts with Medicare and they offer several options, depending on your needs.
Medicare Advantage is really Medicare “Part C” (get it? A, B, C, D…), but it’s been called many things – like Medicare Plus Choice, MAPD, and Medicare Replacement. All of these terms are synonymous – they mean the same thing!
Medicare Replacement can have negative connotations, but there’s nothing to be concerned about. When the term Medicare Replacement is used, it’s simply a clear way of describing what happens when you choose to allow a private insurance company to administer your Medicare entitlement program.
Don’t worry, though, you’re not giving up your Medicare, you’re simply letting your carrier be fully responsible for providing benefits, paying claims, and enriching your plan through additional features and services.
When it comes to Medicare Advantage plans, the key thing to remember is that they are basically an all-in-one alternative to Medicare itself. Individuals who are on a Medicare Advantage Plan still have Medicare, but many plans offer additional coverage – like dental, vision, hearing, health and wellness programs, and more!
How Medicare Advantage Works
Medicare Advantage plans can vary. While they all provide Medicare services, they vary in the particulars.
Some offer, as stated before, additional benefits like dental and vision.
The way this works is relatively simple. First, Medicare will pay a fixed amount each month to your carrier for your coverage. In order to receive these funds, Medicare Advantage plans must follow certain protocols laid out by Medicare. After that, Medicare Advantage plans do have some variances like out-of-pocket costs and whether or not you’ll need a referral in order to see a specialist. These rules can change each year.
What Medicare Advantage Means for You
Medicare Advantage plans are a simple way for you to gain more out of your Medicare and a lot of people are taking “advantage” of them!
In fact, because of a growing number of carriers and robust offering plans, Medicare Advantage plans are enjoying their highest rate of participation in over 30 years – and that number continues to grow. These plans have demonstrated a higher average quality of health outcomes in participants and have been strongly supported by the Medicare Trust Fund and others who legislate our healthcare nationally.
This is great news for you. As these plans grow and increase, the benefits will as well.
How to Choose the Right Medicare Advantage Plan
Choosing the right Medicare Advantage plan depends on you! If it doesn’t meet your needs and expectations (or the needs and expectations of your spouse/loved one) then it’s not the plan you need.
Because there’s so much variance with Medical Advantage plans, it’s often helpful to find a local advisor/agent who can explain exactly what a Medicare Advantage plan provides, how you will benefit from it, and what you can expect going forward. Plus, these agents will cost you nothing!
Agents are paid by carriers, are unbiased towards any one plan, and are really there to help you determine the best plan for you, personally, based on your needs and priorities.
They can even provide ongoing care, no matter what you might encounter with your plan.
Common needs are:
- setting up a Silver Sneakers membership
- helping a mailorder Rx program
- changing mode of premium payment, like checking accounts or social security deduction
So, What’s Medicare Advantage?
To put it plainly, Medicare Advantage is exactly as it sounds. It’s Medicare with additional benefits.
Whether or not those benefits take the form of a Part D Drug plan, dental insurance, vision care, etc., or they include initiatives like gym memberships, wellness rewards, over the counter allowances for the purchase of health-related items, and meals for those recently home from a hospital visit, Medicare Advantage is a simple way to get more out of Medicare.
So, what are you waiting for? Reach out to a Plan Advisor near you to get started!