Who Should Enroll In A Medicare Advantage Plan?

Should you enroll in a Medicare Advantage Plan?

You’re eligible for Medicare. Now what? You have some choices to make. Insuring with Medicare by itself is one option, but you will be subject to some potentially high unpredictable costs. Or you could buy a Medicare supplement, if affordable. Your third option is to enroll in a Medicare Advantage Plan.

Enrolling in this type of Medicare Plan is a popular choice for many people for a number of reasons. But it’s not the best choice for everyone. Who enrolls in a Medicare Advantage Plan is largely determined by individual circumstances. And don’t expect to find a plan that is necessarily considered the best for everyone. You may want to consider an Advantage Plan if you meet any of the following criteria.

You have a limited Budget

Having a limited budget comes into play in a couple ways. First, you may consider enrolling because you will receive all the benefits of original Medicare, but have the benefit of a maximum out-of-pocket amount. If you get your coverage through original Medicare you will not have a cap on your share of costs for covered services. Just the 20% outpatient costs alone could leave you with some budget-busting expenses.

Another reason your limited budget could steer you towards a plan is the high cost of Medicare supplement premiums. Supplemental premiums are usually much higher on average than premiums for Medicare Advantage Plans. Some Advantage Plans have premiums as low as $0 per month.

You want extra benefits

Medicare Advantage Plans include all Part A and Part B benefits, but the private insurance companies offering these plans can include benefits beyond what would normally be available from original Medicare.

It’s common for plans to include Part D drug coverage and some plans may include extras, such as; dental, vision, hearing, gym memberships and transportation. Medicare supplement policies rarely include these extras and supplemental policies are not currently offered with drug coverage built-in.

You want an all-inclusive plan

If you want one plan that includes your medical and Part D drug benefits you will need to consider an Advantage Plan. If you enroll in a Medicare Advantage Plan with drug benefits (MAPD) you will only interact with one insurance company which could limit interaction with multiple member service departments.

You may not qualify for a Medicare supplement

Unless you are in your Medigap Open Enrollment Period or entitled to Guaranteed Issue Rights, you will generally be subject to medical underwriting when buying a Medicare supplement. Some pre-existing conditions or recent hospital stays could mean a denial for coverage.

Some States do not require insurance companies to offer Medicare supplemental coverage to Medicare beneficiaries under 65. And in those States that do, premiums can be much higher for beneficiaries under 65.

Those are some of the reasons you may want to enroll in a Medicare Advantage Plan. And for some people, it’s the only option other than original Medicare.