How to Choose a Medicare Advantage Plan

Medicare's Annual Election Period (AEP) is coming up between October 15-December 7, and it is a critical time to review your Medicare Plan.  Because of the limited time frame, you’ll be receiving A LOT of advertisements—by mail, email, social media, radio, newspapers, phone calls, and television.  It WILL be overwhelming!

Medicare Advantage Plans are a popular plan choice for many Medicare recipients.  Currently, about 35% of Medicare beneficiaries are on a Medicare Advantage Plan, with projected enrollments to rise to about 50% by the year 2024.

Is a Medicare Advantage Plan right for you? Obviously, many people think so.  There are more and more plan offerings every year, so it would be wise to at least review the options available to you. 

(This is NOT a blanket recommendation to take a Medicare Advantage Plan.  Please discuss your situation with an agent to determine if this is a suitable plan for you).

Some Medicare beneficiaries have over 20 Medicare Advantage Plans available where they live.  They are not all created equal! When comparing Medicare Advantage Plans, there are some key points to consider.  For every plan you look at, make sure to ask these questions:

Network—Most Medicare Advantage Plans have a network.  Is this plan an HMO or a PPO? Are your doctors in network for the plan, or would you need to change doctors? What would happen if you went out of network with this plan?

Referrals—Are specialist referrals required by this plan?

Premium—What is the plan’s monthly premium? Does it fit into my budget?

Co-pays/Co-insurance—What out of pocket expenses would/could you incur?

Maximum Out Of Pocket—All Medicare Advantage Plans have a Maximum Out of Pocket amounts. Compare this to see what your “worst case scenario” could be.

Prescription Drug Coverage—Is Part D included with this plan? If not, can you add Part D to the plan? What are the prescription co-pays? Are all your drugs covered on the plan, or would you need to change your medications? Is your pharmacy in the preferred network, or would you need to change pharmacies?

Extra Benefits—Many Medicare Advantage Plans have extra benefits, like gym memberships, dental, vision, hearing aids, meal programs, weight loss programs, Over the Counter supplies, and more.  Compare the options between different plans to see which would benefit you the most.

Agent/Broker—will you have a dedicated agent you can reach out to? If you have questions, is the agent available to help you?

These are some of  the key points to consider when choosing between Medicare Advantage Plans.  There’s a lot to digest! Independent brokers will be able to help you analyze and choose plans based on your situation, so you won’t have to do the heavy research if you don’t want to. 

As always, I certify with all the top carriers, and I do the heavy lifting for my clients and prospects.  Please feel free to call me at 815-232-7726 or email me at [email protected] with any questions, or to schedule a time to discuss your Medicare Advantage options!

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Author

Angela Damin, Your Medicare Teacher, is an award winning Medicare planning broker with over a decade of experience in the Medicare field.  She meets people in person, over the phone, and via video chat.  Angela has a Masters Degree in Education and taught elementary school before  switching her subject matter to the Medicare realm. She spends her spare time chasing her twin toddlers.