Medicare Misconception: “Medicare Advantage Plans Are Complicated”

Medicare can be complex to understand. When it comes to Medicare Advantage (MA) plans, some may think, “Medicare Advantage plans are complicated and hard to understand.” Our client advisors are experts on this subject and are here to walk you through MA plans in a simple, easy-to-understand way.

All-in-One Plan, Low Cost Approach Explained

If you are looking for an all-inclusive plan, MA may be a good option for you. MA plans are offered by private insurance companies and include the same coverage offered by Original Medicare. MA plans also have additional benefits that Original Medicare does not cover. For example, Medicare Advantage with Prescription Drug Coverage (MAPD) combines medical and prescription drug coverage. Many of these plans have a low or $0 monthly premium. This makes it easier to keep track of your health care expenses.

MA plans come with an out-of-pocket maximum that protects you from high medical expenses, since it caps the total annual amount you’ll be responsible to pay out of pocket for health care costs. Once you reach your out-of-pocket maximum, your MA plan will cover all other expenses for qualified medical costs. It’s important to note that an out-of-pocket maximum is not the same as a deductible.

Copays Explained

A copay, which is a fixed dollar amount that you pay each time you visit the doctor, is part of the MA plan structure. Medicare Supplement plans don’t have copays, but they have a monthly premium that increases annually. Many MA plans have a $0 premium and they allow you to pay copays as you use your plan versus paying a guaranteed premium. As mentioned, with an MA plan, you also have an out-of-pocket maximum which gives you a safety net for your health care spending.

Benefits Explained

MA plans include a variety of great built-in benefits. These benefits offer convenience and may include:

  • Telehealth benefits
  • Over-the-counter allowances
  • Dental coverage
  • Hearing coverage
  • Vision coverage
  • Fitness memberships

Networks Explained

Each MA plan has a list of specific doctors, hospitals, and providers that are considered “in-network.” Most MA plan networks are quite large and often include multiple hospital and provider systems across your state. Read more about MA plan networks in our recent blog post.

How We Can Help

Our client advisors are here to answer your questions about MA plans. If you want to learn more, reach out to us at 1-877-222-1942 or [email protected]

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