Advantage plans are heavily advertised because of how they are funded. These plans' premiums are low or nonexistent because Medicare pays the carrier whenever someone enrolls. It benefits insurance companies to encourage enrollment in Advantage plans because of the money they receive from Medicare.
A possible disadvantage of a Medicare Advantage plan is you can't have a Medicare Supplement plan with it. You may be limited to provider networks. The Medicare Advantage program, also known as Medicare Part C, provides a way you can get your Original Medicare (Part A and Part B)
The Best Medicare Advantage Providers of 2023
According to MoneyGeek's scoring system, the top-rated Medicare Advantage plans are Blue Cross Blue Shield for preferred provider organizations and UnitedHealthcare for health maintenance organizations.
For many seniors, Medicare Advantage plans can work well. A 2021 study in the Journal of the American Medical Association found that Advantage enrollees often receive more preventive care than those in traditional Medicare. But if you have chronic conditions or significant health needs, you may want to think twice.
Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.
The biggest disadvantage of Medicare Advantage plans is the closed provider networks, limiting your choice of which doctor or medical facility to use. Medicare Advantage costs are also largely based on how much medical care you need, making it more difficult to budget for health care costs.
Top 3 Reasons People leave Medicare Advantage plans:
Unhappy with the additional benefits. A limited network of doctors. Unreasonable cost-sharing.
Medicare Advantage beneficiaries are extremely satisfied with their health care coverage. 98% of beneficiaries say they are satisfied with their Medicare Advantage plan, and 97% express satisfaction with their network of physicians, hospitals and specialists.
Because of a number of factors, like lower reimbursement rates, paperwork, and regulations, some doctors choose to opt out of Medicare.
It is clear from Wakely's study that rather than being more expensive than original Medicare, MA is actually significantly less expensive, even accounting for all the extra benefits and services the program provides.
Under attained-age pricing, Medicare costs and the price you pay for your Medicare Supplement plan is based on your current age, or the age that you “attained” the policy. Unlike plans based on community-rated pricing or issue-age pricing, your premium goes up as you get older.
While insurers typically offer a range of plans, Aetna is the cheapest Medicare Advantage provider with an average cost of $7 per month.
Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan.
You may be dropped from a Medicare Advantage plan if it becomes unavailable or if it no longer services your area. You may also be dropped from a Medicare Advantage plan if you don't make your payments within an agreed-upon grace period.
Forty-five percent of Medicare beneficiaries are enrolled in Medicare Advantage plans in 2022, a share that is projected to rise to more than 50 percent by 2025.
Hard Sell Medicare TV Commercials
Many of the ads are hard sell, placed primarily by insurance brokers representing specific plans that want to boost their enrollment numbers.
UnitedHealthcare has had the largest share of Medicare Advantage enrollment and largest growth in enrollment since 2010, increasing from 20 percent of all Medicare Advantage enrollment in 2010 to 28 percent in 2022.
House progressive bill wants to take Medicare out of Medicare Advantage's name. New legislation from two House progressive lawmakers wants to change the name of Medicare Advantage (MA) to “alternative private health plan,” the latest criticism of the program ahead of open enrollment.
In 2022, the average enrollment weighted MA-PD premium, including among those who do not pay a premium, is $18 per month. However, average MA-PD premiums vary by plan type, ranging from $16 per month for HMOs to $20 per month for local PPOs and $49 per month for regional PPOs.
The estimated average monthly MA plan premium for 2023 is $18, but this cost may vary significantly. Some plan premiums could be $0, while others could have premiums over $200. To join a Medicare Advantage plan, you must also be enrolled in Medicare Parts A & B.
Plans may have lower out-of-pocket costs than Original Medicare. Plans may offer some extra benefits that Original Medicare doesn't cover—like vision, hearing, and dental services. service area (for non-emergency care). Some plans offer non-emergency coverage out of network, but typically at a higher cost.
While most Medicare enrollees do not pay a monthly premium for Part A, which covers inpatient hospital, skilled nursing facility, hospice and some home health care services, a deductible is charged for each hospital stay. For 2023, the Part A deductible will be $1,600 per stay, an increase of $44 from 2022.