Original Medicare vs. Medicare Advantage Plans


When an eligible US citizen turns 65 years old, they can apply for Medicare Insurance on the website.  Regular health insurance will stop once a person turns 65 years old. As a senior citizen, you probably know, there are alternatives to original Medicare (Part A & Part B) you have a choice of selecting a Medicare Supplemental plan (also called Medigap plan) or a Medicare Advantage plan (Part C).

Nowadays, many seniors prefer to go with a Medicare Advantage plan over original Medicare since they are required to cover the same things at a minimum and have additional benefits, plus the out of pocket expenses may be lower since there is an annual limit on the out-of-pocket-max.

Most seniors have a difficult time deciding which insurer or what level of coverage to purchase if they have never researched it. Regardless of whether you are concerned about your medical costs of the future or just the ones you are going through now, learning about Advantage plans to replace your Medicare will be a good idea.

Who Sponsors Medicare Advantage Plans?

You need to understand that structure of all insurance companies in the United States revolves around making money. As a result, they only agree to take on the risk of seniors medical bills because they think that they can make a profit, they are accepting that sort of risk on the basis that they will make more money then that have to spend.

Ordinarily, the federal government assists in funding the advantage plan, through the premium paid for Part B by the Medicare recipient, as well as the premium that is paid directly to the company. In these situations, the insurance company will most probably end up generating revenue simply because they’re able to designate deductibles and excess charges to its consumers and also have access to specialists to invest those funds.


Medicare Advantage Plans- Costs

Original Medicare plan (Part A & Part B) and Prescription Drug Plan (Part D) plus a supplemental plan cost a great deal more than any Medicare Advantage plan on the market. For instance, there are a ton of Medicare Advantage plans that are absolutely free for all seniors have already enrolled in Medicare Part B. The seniors are required to continue to pay for Part B and whatever the co-pays and the deductibles are for that particular Medicare Advantage plan. That premium for Part B to be paid by person straight to the government. Those co-pays and deductibles will still be there depending on how comprehensive your Medicare Advantage plan is.

Extra Benefits Of Medicare Advantage Plans

With Medicare Advantage plans you’ve got several additional benefits usually embedded into the plan that is great to take advantage of additional coverage that you will not find with traditional Medicare.

In the Medicare Advantage plan, you may receive basic dental coverage to have your teeth cleaned and examined, yearly vision exams, discounted hearing tests, Silver Sneakers program at local gyms.

Regardless, to utilize some of these benefits, the insurer might require you to get a referral from your primary doctor, especially if you select an HMO network, plus you are going to have to go with a doctor within their network. As you shop for a Medicare plans, you are going to realize that insurance companies all charge different prices for Medicare Advantage plans whether they are PPO or HMO networks.  You should work with an Insurance agent or shop on-line to compare prices. Read the booklets and compare:

* drug prices

* look-up all your doctors to see if they are in the network

* check out co-pays to see primary care physician or a specialist

* co-pays for x-rays, CT scans, imaging services

* compare the deductible amount

* compare yearly out-of-pocket-maximum.

* review services you normally use

With the sky-rocketing costs of health care, patients, and the federal government are starting to contemplate on how exactly they are going to manage the costs of their medical care obligations. As the current system comes closer to collapsing, most are considering a private insurance company to handle their affairs. These days, Medicare Advantage (Part C) plans are the perfect solution for all Medicare recipients, the federal government partly sponsors them, and they help cut costs.

An advantage plan is an awesome alternative to Original Medicare but it is not for everyone.

The original Medicare coverage is great for seniors who are looking for a high-quality healthcare option, but the problem is that it only pays 80% of all medical expenses.  The policyholder is still responsible for 20% of all bills generated, and there is no annual limit.  And this is the place where Medicare Supplement plans come in.

Medigap policies or supplemental policies sold by the private insurance companies will fill predictable gaps in Medicare, these types of policies are required to pay the share of health care expenses which are not covered by original Medicare alone. Having a blend of these two categories of plans is ideal for getting the best coverage.

Medicare supplemental plans cover the same things as required by law, for example, all F plans cover the same no matter which insurance company sells the plan.  However, the prices may vary greatly, so it is worth shopping around for Medicare supplemental policies.

So Medicare Advantage plans will help you to replace your Original Medicare benefits are divided into part A and B with the coverage via a private insurance organization. Most of the Advantage plans include additional benefits to be more competitive. For instance, there are lots of people who need dental services, eyeglasses, hearing aids and all these are usually part Medicare Advantage.

Each of the Medicare Advantage plan has their rules and regulation, but all of them must follow the guidelines made by Medicare. All Advantage plans must provide same or quite better coverage than original Medicare. But make sure that you will be able to obtain the health care benefit you require, you can check the list of doctors and the prescriptions before you enroll. Open enrollment is once a year is starting on October 15 until December 7.  If you change your mind about an Advantage plan, you can change back to original Medicare between January 1 and February 14, and this is called Medicare Disenrollment Period.

You can change your Medicare plans every year during the open enrollment period, and after that, you are locked in for that calendar year unless you disenroll during the appropriate period.