Is Medicare Advantage Right for You? Here Are the Pros and Cons

When you sign up for standard Medicare, Part A, and Part B, you get standard hospital coverage as well as outpatient services.  However, people wanted more choice in how their Medicare was handled, so in 2004 Medicare Part C – also called Medicare Advantage – was introduced.

Unlike some other Medicare options, Medicare Advantage is privately administered.  You get coverage through a Medicare insurance agent, working for a private company.  This introduces some major new benefits to the program, but there are also some drawbacks you might need to know about.

Here are some of the most important pros and cons.

Four Benefits to Signing Up for Medicare Advantage with A Medicare Insurance Agent

1. Many plans are low-cost

There are a number of Medicare Advantage plans that cost nothing to sign up for, and the cap on yearly out-of-pocket expenses is relatively low too – only a few thousand dollars.  This makes them easy to afford.

2. Hearing and dental may be included

Hearing and dental are not in standard Medicare Parts A and B, so this can be a big draw if you need these services.

3. Drug coverage

Likewise, you usually won’t get medications through Medicare A or B.  Prescription drugs are typically covered through a Medicare Advantage plan.

4. Easy to switch plans

There’s an open enrollment period every year when you can change your Medicare Advantage plan without penalty.  This makes it easy to shop around.

Three Disadvantages to Medicare Advantage

1. No two plans are alike

Because Medicare Advantage is entirely administrated by private insurers, they come up with their own plans.  You will need to do a lot of research to find the right Medicare Advantage plan.

2. They have some of the drawbacks of standard insurance

You typically still have to pay co-pays and co-insurance fees, and you will probably be in an HMO-style plan that requires referrals to in-network specialists.  This can be inconvenient.

3. Coverage isn’t nationwide

Also, as with standard insurance, your Medicare Advantage policy is likely to be restricted to your state of residence.  If you travel and need coverage, you may have difficulty finding a provider.

Is Medicare Advantage Right for You?  

Good & Associates is a top-quality California insurance company, providing Medicare Advantage plans as well as private policies.  To learn more about the specifics of Medicare Part C, and your options in insurance plans, call us for the details.