A Medicare Advantage plan, also known as Medicare Part C or "MA" plan, is a type of Medicare coverage offered by a private insurance company. When you enroll in a Medicare Advantage plan, all of your Medicare Part A hospital and Part B medical services are covered by the plan. In most cases, when you enroll in a MA plan, you pay a monthly premium in addition to your Medicare Part B premium, but there are some benefits to doing so.
Additional Benefits
Many Medicare Advantage plans offer coverage that Medicare doesn't. For example, some MA plans offer vision, dental, and health and wellness benefits, such as gym membership discounts, to members. These benefits are not available through Medicare, so Medicare beneficiaries generally must pay out of pocket for those services. Purchasing an MA plan to cover those services offers substantial savings to some people. In addition, as of 2011, Medicare Advantage plans have new rules in place that may lower the costs for anyone participating in a clinical research study.
Prescription Coverage
In most cases, Medicare Advantage plans include Medicare Part D prescription drug coverage. When you enroll in Medicare, you are required to choose a prescription coverage plan to avoid penalties, but enrolling in MA generally helps you avoid choosing and paying for a Part D plan. Each MA plan has its own list of covered drugs, and co-pays can vary between plans, so confirm that your medications are covered before choosing a plan.
Less Premium
Cost savings is another benefit of MA plans for some Medicare beneficiaries. The monthly premiums for Medicare Advantage plans are usually lower than those of Medicare supplement plans. A Medicare supplement, also known as Medigap, is a plan that covers services not covered by Medicare Part A and B and pays some or all of the Medicare co-payments. A Medicare Advantage plan, in contrast, has a lower monthly premium, but you are responsible for paying the co-payments set by the insurance company. If you only visit the doctor on occasion, a Medicare Advantage plan might save you some money over a Medicare Supplement plan.
Out-of-Pocket Maximums
Medicare Advantage plans generally have a maximum out-of-pocket cost for their members. This means that how much you pay each year for co-pays and deductibles is limited. If you have substantial health issues, you could save a lot of money over original Medicare. For example, if you are covered under Medicare Parts A and B only, and require ongoing medical treatments for cancer, you must pay a percentage of the costs for as long as you receive treatment -- even if your treatment costs hundreds of thousands of dollars. With an MA plan, your maximum out-of-pocket costs are capped each year.
Tags: Medicare Advantage, Advantage plans, Medicare Advantage plans, Medicare Part, Advantage plan
