If you have been receiving Medicare benefits for awhile but your health needs exceed the limitations of coverage offered under Part B, it’s heartbreaking watching your hard-earned savings go towards purchasing additional plans or budget-busting out-of-pocket costs. Let’s face it: as we get older our health care needs naturally increase and for many seniors, basic coverage offered by Part B just doesn’t cut it. What many Medicare recipients don’t know is that there is another choice available to them called Medicare Advantage (or Part C). In a nutshell, Medicare Advantage plans offer more benefits for roughly the same cost as Part B premiums. Too good to be true? No! Read on…
How Medicare Advantage Came to Be
Recognizing that Part B isn’t enough for many seniors, the federal government entered into specific agreements with a wide range of private insurance companies: allowing them to offer consumers more benefits and more choices in coverage. All providers must be Medicare-approved and the quality of care must meet or exceed that received through Part B. An Advantage plan is Medicare replacement insurance, not a supplement; and for many seniors, it is an ideal way to get more targeted benefits for their specific needs without paying an arm and a leg to get them.
How It Works
When you enroll in a Medicare Advantage plan, you agree to work directly with the private insurer vis-à-vis claims and other billing matters as well as care providers. You will no longer be a part of Original Medicare and will use a company-issued card for all transactions. However, you should keep your original card in a safe place in case you ultimately decide to return to Part B coverage.
Your Part B premiums will still be deducted from your Social Security check, but instead of going into the Medicare pot, the agency will use the money to reimburse the private insurer. Most seniors work with an insurance broker to help determine which company will offer the best choice in benefits to meet their specific needs. In many cases, your premiums will not increase at all from those you are paying for Part B even though you receive more benefits. In other cases, you will pay a little more each month for specific benefits, but the amount paid will still be substantially lower than the cost for supplement plans or paying out-of-pocket.
Examples of Additional Benefits
Every insurance company offers different plans and different benefit packages: that’s why it’s so important to work with a broker who can help you sort through your choices and make an educated and cost-effective decision. Some examples of additional benefits offered through Medicare Advantage plans may include:
- Better hospital stay coverage
- Expanded coverage for prescription medications
- Better dental benefits
- Hearing/Vision benefits
- Coverage for Medicare medical equipment
- Specific limits on out-of-pocket costs
- Transportation services to health care facilities
- And more
Original Medicare can be a wonderful thing: providing basic low-cost health care to the elderly as well as the disabled. But if your specific needs are costing you a fortune and Part B just isn’t doing the job, perhaps now is the time to look further into the benefits of enrolling in Medicare Advantage.
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