If you're 65 or over, you might have received mail from several health insurance companies in recent weeks. Some seniors could have quickly tossed the mail in the trashcan. Others, though, might have had their curiosity piqued.
It's open enrollment season for Medicare. As a result, companies that offer Medicare Advantage plans are stepping up their marketing efforts. Previous efforts to reach seniors appear to have worked quite well. More than half of eligible Medicare beneficiaries have signed up for Medicare Advantage plans.
Thinking about enrolling in Medicare Advantage? Here's what you need to know.
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What are Medicare Advantage plans?
Medicare Advantage plans are offered by private companies that contract with Medicare. These plans must include the hospital benefits available in Medicare Part A and the other medical benefits available in Medicare Part B. They also typically include the prescription drug benefits available in Medicare Part D plans.
Some Medicare Advantage plans provide benefits that Original Medicare doesn't cover. For example, many of these plans offer dental, hearing, and vision benefits that aren't included in traditional Medicare benefits.
Seniors typically must pay 20% of services covered by Medicare Part B after meeting their deductible. Your out-of-pocket costs can be lower with some Medicare Advantage plans for certain services. However, it's also possible that out-of-pocket costs could be higher with some Medicare Advantage plans. Importantly, though, Medicare Advantage plans have a maximum annual out-of-pocket limit, whereas Original Medicare doesn't.
Generally speaking, the premium costs for Medicare Advantage plans are lower than the combined costs for Medicare Part B plus Medicare Supplement (also known as Medigap) plans. But your out-of-pocket costs will usually be lower if you have a Medicare Supplement plan than with a Medicare Advantage plan.
The biggest limitation with Medicare Advantage plans is that you'll only be able to use healthcare providers that are in the plan's network. With Original Medicare, you can use any healthcare provider in the U.S. that accepts Medicare.
How to compare different Medicare Advantage plans
There are several websites that can help you compare different Medicare Advantage plans that are available in the area where you live. Before you start looking into different Medicare Advantage plans, though, first determine what benefits you really need. You don't want to pay for services you won't use.
You'll obviously need to look at the premiums charged by the various Medicare Advantage plans you're considering. Keep in mind, however, that premiums don't give a full picture of what your total costs might be. It's also important to examine the out-of-pocket deductibles and maximums for each plan.
Check out the provider networks for each Medicare Plan as well. If the healthcare providers that you currently see or prefer aren't on the list for a given plan, you might want to rule it out. Some Medicare Advantage plans do allow members to use doctors and hospitals outside of their networks, but the costs could be higher.
The Centers for Medicare and Medicaid Services (CMS) also provides star ratings for every Medicare Advantage plan. These ratings range between one and five stars. They measure the performance of all Medicare Advantage plans on 38 measures, including care coordination and customer service. While these star ratings shouldn't be the only factor you use to pick a plan, they can help you in making a decision.
Key deadlines coming up
If you're currently enrolled in Original Medicare, you can join a Medicare Advantage plan through Dec. 7, 2023. Your coverage will begin on Jan. 1, 2024.
There's a different open enrollment period for individuals already in a Medicare Advantage plan, though, that extends from Jan. 1, 2024, to March 31, 2024. During this period, you can switch to another Medicare Advantage plan or return to Original Medicare.
