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6 surprising benefits of Medicare Advantage plans

6 surprising benefits of Medicare Advantage plans

The government provides Medicare and health insurance for older individuals over 65 or those with disabilities or life-long diseases like kidney failure. Medicare can pay for one’s treatments and take off some of the financial burden during emergencies. Medicare Advantage plans act as an add-on service approved by Medicare but provided by private health insurance companies. These provided all the benefits of Medicare plus added benefits that the federal government doesn’t cover.

What is a medicare advantage plan?
Medicare has different types of plans. The most common ones are Original Medicare, Part A, and Part B. Part A is also called hospital insurance. As the term suggests, it covers all inpatient service costs, home care services, and nursing expenses of the patients when admitted to the hospital. Part B is medical insurance and covers medical supply expenses, routine doctor visits, outpatient care, and preventive services.

One can also sign up for a Medicare Advantage Plan (Part C). Apart from providing all the benefits of the previous two plans, Part C provides added coverage like vision, hearing, dental, and health and wellness programs. These plans are also referred to as “MA Plans,” and private companies approved by Medicare offer them to customers. In addition to these three, there’s also Part D for Medicare plans, which covers vaccines and prescriptions.

Types of Medicare Advantage Plans
Medicare Advantage plans can be of the following types:

  • Health Maintenance Organizations (HMOs) prioritize primary care physicians and require referrals for specialists.
  • Preferred Provider Organizations (PPOs) offer flexibility in choosing healthcare providers without referrals.
  • Special Needs Plans (SNPs) cater to individuals with specific chronic conditions or disabilities.
  • Private Fee-for-Service (PFFS)

How Medicare Advantage Plans work
Medicare disburses a set amount monthly to the approved health insurance providers to pay for the insurer’s care. The private companies must follow certain rules set by Medicare to be able to offer the plan, but these rules may differ from one plan to another. In some cases, there may be different out-of-pocket costs, while others may vary in the choice of services one opts for, like preferred doctors and facilities. These rules change frequently, so one should read them thoroughly before signing up for an advantage plan.

Surprising benefits of Medicare Advantage Plans
These are some of the surprising as well as straightforward benefits that Medicare Advantage plans offer:

1. Lower out-of-pocket costs
Original Medicare requires people to pay around 20% of their healthcare expenses, and there is no cap on out-of-pocket spending. However, with a Medicare Advantage plan, one can also get those 20% expenses covered. So, this directly removes the beneficiaries’ financial burden and reduces overall healthcare expenses.

2. More coverage
Medicare Advantage plans must offer at least the same level of coverage as original Medicare, but many plans also offer additional coverage, such as dental and vision coverage. This  means one can get more care in one place without worrying about coordinating separate insurance plans.

3. More predictable costs
Medicare Advantage plans provide a predictable monthly expense for people. They have reduced premiums, deductibles, and co-pays compared to original Medicare. Premiums are the monthly fee one pays the insurance company for coverage; deductibles are out-of-pocket expenses before the insurance starts covering costs; and co-pays are the fixed amounts one pays for healthcare services when receiving them. These lower costs contribute to a more manageable budget for one’s healthcare expenses.

4. Coordinated medical care
Another perk of Medicare Advantage plans is that most offer coordinated medical care, wherein healthcare providers communicate and coordinate one’s required healthcare amongst different healthcare facilities and doctors if needed. This  helps greatly since, with this benefit, a patient can have a dedicated healthcare team that schedules appointments, manages prescriptions, and takes care of other tasks not covered under the original Medicare.

5. Extra perks
Many people do not know that some Medicare Advantage plans also offer extra services. These may not be directly related to hospital expenses but are related to health and transportation. These may include gym memberships, transportation assistance, and over-the-counter medical cover. Add-on perks may not seem like much at first glance, but they often compound over time and significantly boost one’s savings.

6. Option to personalize plans
With Medicare Advantage, one can customize the plan structure. For example, those dealing with a chronic health condition can find relief in an SNP Advantage plan, which specifically addresses medical expenses related to specific conditions. Similarly, for   those looking for more flexibility while choosing a healthcare provider, plans like PPOs and PFFS can be better.

That said, it’s essential to communicate one’s specific requirements to Medicare brokers or advisers. One can contact Medicare’s sales team in their locality through Medicare’s official website and schedule a consultation. These experts are better equipped to handle individual needs and provide personalized guidance on selecting the most suitable Medicare Advantage plan.