Is Medicare Advantage or Part C Right For You?

When you become Original Medicare qualified (typically when you turn 65 years old) you will find that you will not have 100% coverage. You can exercise a couple of options to fill that gap. One option is the Medicare Supplement option. We will discuss this in a separate post. The other option is enrolling in a Medicare Advantage Plan. So, what is the “advantage” of the latter option? First, a summary of what Original Medicare is.

Original Medicare

Original Medicare has two parts, Part A and Part B.

Part A, also known as Hospitalization coverage. The gap in Part A is a deductible is $1364 for every 60 days. Also there is a $341/day copay starting the 61st day of hospitalization.

Original Medicare Part B gap is the $185 annual deductible and, after paying the deductible, 20% coinsurance with no maximum out of pocket. Unlike traditional health insurance where there is a dollar amount you spend and after you hit it the plan pays 100%, Part B does not have this benefit.

Another gap with Original Medicare is that it does not have prescription drug plan coverage. This is offered by private health insurance companies for an additional premium.

Is Medicare Advantage Right For You?

As with anything, it all depends if a Medicare Advantage Plan is right for you. Here are some items to consider when comparing Original Medicare and getting a Medicare Advantage Plan.

  • You may like the flexibility of seeing any provider or going to any facility, so long as they accept Original Medicare and assignment as payment from Medicare in full.
  • If you choose the Original Medicare and Medicare Supplement route you are responsible for coordinating or your care and records with the various providers and specialist you see with Original Medicare.
  • When you sign up for a Medicare Advantage Plan, it takes over Part A and Part B from Original Medicare and becomes the primary payer. Instead of the deductibles and large copays, you will have either no or small copays. Medicare Advantage Plans also have a Maximum Out of Pocket on an annual basis so no matter what expensive illness or injury  you may have, you can be sure that you will not suffer a financial catastrophe
  • Medicare Advantage Plans include a Part D prescription drug plan. Many plan have zero premium.
  • There are many additional benefits included with a Medicare Advantage Plan like
    • Dental coverage
    • Vision Coverage
    • Hearing Coverage
    • Gym Membership
    • Over-the-counter allowance
    • Overseas coverage

There are many plans available. Physician networks and coverage vary from plan to plan. We can help you pick the plan that is right for you. Also with the plans we represent, we help you keep your doctor. We are medicare brokers who work for you and not the insurance companies.  Contact us for a no-cost consultation to find a plan that is right for you.