Why did one-third of all Medicare beneficiaries choose to enroll in a Medicare Advantage plan (Medicare Part C) going into 2019?1 And what benefits could you possibly get from enrolling in a Medicare Advantage plan?
Here are three reasons why more than 22 million people are expected to enroll in Medicare Advantage plans in 2019.
Medicare Advantage plans include an out-of-pocket limit for services and items covered by Medicare Part A and Part B.
In recent years, the highest out-of-pocket spending limit a Medicare Advantage plan could have was $6,700 for in-network services.2
Medicare Advantage plans are free to establish their own out-of-pocket limits as long as they are below these maximum limits, and many plans may feature out-of-pocket limits that are significantly lower than the maximum.
Once this annual limit is reached, the Medicare Advantage plan pays for 100 percent of covered services for the remainder of the year.
Original Medicare (Part A and B) has no out-of-pocket limit. This means beneficiaries could be responsible for an unlimited amount of medical bills over the course of a year, with no end in sight.
Many seniors might choose Medicare Advantage because of the financial protection that can be offered in the event of a serious health complication.
Original Medicare does not typically provide coverage for prescription medications. And considering 25 percent of Americans aged 65-69 take 5 or more prescription drugs, that lack of coverage could make for high out-of-pocket costs for some Medicare beneficiaries.3
Medicare beneficiaries with prescription drug needs are typically left with two options for coverage: a Medicare Part D plan, which provides coverage exclusively for prescription drugs, or a Medicare Advantage plan that includes prescription drug coverage.
Depending on the type of drug and the plan, a Medicare Advantage plan with prescription drug coverage (known as an “MA-PD”) could be less expensive than a Part D plan. In fact, the average monthly premium paid for a standalone Part D plan in 2017 was $40,4 while the average amount paid for an MA-PD was $36.5
Prescription drug coverage isn’t the only extra benefit that may be offered by many Medicare Advantage plans.
For example, Part A and B of Medicare do not provide coverage for routine dental, vision or hearing care. Many Medicare Advantage plans, however, offer coverage for some of these benefits.
The list of benefits that a Medicare Advantage plan can offer is set to continue growing in 2019, to include benefits such as:
The additional benefits offered by many Medicare Advantage plans can be a big draw for many seniors looking to bolster their health coverage.
Are you considering the move to choose a Medicare Advantage plan? Compare the Medicare Advantage plan options available where you live by speaking with a licensed agent.
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1 Kaiser Family Foundation. Medicare Advantage 2019 Spotlight: First Look. (Oct. 16, 2018). Retrieved from www.kff.org/medicare/issue-brief/medicare-advantage-2019-spotlight-first-look.
2 Kaiser Family Foundation. Medicare Advantage 2016 Data Spotlight: Overview of Plan Changes. (Dec. 3, 2015). Retrieved from www.kff.org/report-section/medicare-advantage-2016-data-spotlight-overview-of-plan-changes-limits-on-out-of-pocket-spending.
3 Charlesworth, Christina; Smit, Ellen; Lee, David; Alramadhan, Fatimah; Odden, Michelle. (Mar. 1, 2015). Polypharmacy Among Adults Aged 65 Years and Older in the United States: 1988-2010. The Journals of Gerontology Series A, 70 (8), 989-995. https://doi.org/10.1093/gerona/glv013
4 Kaiser Family Foundation. Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing. (May 17, 2018). Retrieved from www.kff.org/medicare/issue-brief/medicare-part-d-in-2018-the-latest-on-enrollment-premiums-and-cost-sharing.
5 Kaiser Family Foundation. Medicare Advantage. (Oct. 10,2017). Retrieved from www.kff.org/medicare/fact-sheet/medicare-advantage.
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