Time to review Medicare Advantage
If you want to enroll in Medicare Advantage for the first time, or you are already in the program but want to change plans, this is the time. You have until January 31, when the open enrollment period ends. You can also return to Original Medicare during this time if you think it is convenient. Most Medicare beneficiaries change their plans because their doctors are no longer in that plan, or because they no longer cover the drugs they need. If you have questions, and to help you decide, here are some comparisons between Original Medicare and Medicare Advantage in terms of overall features, coverage, and costs. At a glance , the main features of both plans are: Original Medicare Includes Part A (hospital insurance) and Part B (medical insurance) If you want drug coverage, you can have a separate Part D plan to help with the costs of out of pocket (like 20% coinsurance), you can also buy supplemental coverage (for example Medigap) .You can go to any doctor or hospital that accepts Medicare, where anywhere in the United States. In most cases, you do not need an order from your primary care physician to see a specialist. Medicare Advantage offers a “single window” with bundled plans including Part A and Part B, and generally Part D. These plans may have lower out-of-pocket costs than Original Medicare. In most cases, you’ll need to use doctors who are in the plan’s network. Most plans offer extra benefits that Original Medicare doesn’t cover. , such as vision, hearing, dentistry and more You may need an order to see a specialist The ability to see any participating doctor or go to any hospital is for many an advantage of Original Medicare over Medicare Advantage Especially with the rise in age-related medical conditions Another important comparison to make is the cost of both plans Original Medicare Costs For Part B of services , you will usually have to pay 20%, until you reach your deductible. You pay a premium for part B, and another for part D, if you choose, to have drug coverage. There is no annual limit on what you pay out of pocket Unless you have coverage (like a Medigap policy). You can get supplemental coverage (like a Medigap policy) to help pay for remaining out-of-pocket costs (like your 20% coinsurance). Or you can use coverage from a former employer or union, or Medicaid. Medicare Advantage costs Out-of-pocket costs vary and can sometimes be lower than Original Medicare. You can pay a plan premium in addition to a monthly premium for the Part B. (Most include prescription drug coverage). Plans can have a $ 0 premium or can help pay for all or part of Part B premiums. Plans have a yearly limit on what you pay out of pocket for services covered by Medicare Part A and B. Once you reach your plan limit, you will pay nothing for services covered by Part A and Part B for the rest of the year. You cannot buy or use supplemental coverage. Finally, the essential differences in coverage Original Medicare coverage Original Medicare covers most of services and supplies needed in hospitals, doctor’s offices, and other healthcare settings You can purchase a separate Part D plan to cover your medications In most cases, you don’t need to get prior approval for a service or supply to be covered. Medicare Advantage Coverage Plans must cover all medically necessary services that Original Medicare covers. Most plans can offer extra benefits that Original Medicare doesn’t cover, like vision, hearing, dentist, and more. Plans may now cover more of these benefits than in the past. Drug coverage is included in most plans. In some cases, you must get an approved service or supply in advance to be covered by the plan. Sources: medicare.gov, CMS.