Do seniors need to be wary of Medicare Advantage plans?
Medicare Advantage (Medicare Part C) is basically a replacement for traditional Medicare. With Medicare Advantage you purchase a private health care plan that replaces almost all of Medicare Part A (hospitalization), Medicare Part B (medical), Medicare Supplemental (Medigap) plans and many times Medicare Part D (prescription). You cannot get a Medicare Supplemental Plan (Medigap) if you sign up for Medicare Advantage.
While some 57 million people are still on traditional Medicare, Medicare Advantage plans are being marketed heavily. Enrollment in Medicare Advantage plans is approaching 22 million people.
Many Medicare Advantage (Medicare Part C) plans offer $0 premiums and extra perks that don’t exist in standard Medicare, like vision and hearing coverage and gym memberships. Medicare Advantage plans also cap enrollees’ out-of-pocket expenses.
Traditional Medicare, by contrast, has higher out-of-pocket costs that usually require people to buy supplemental medical policies, called Medigap plans, as well as separate drug plans.
Yes, but: Federal marketing materials rarely mention Medicare Advantage’s (Medicare Part C) tradeoffs.
Medicare Advantage plans limit which doctors and hospitals people can see, and they require prior approval for certain procedures. Provider directories also are loaded with errors.
Medicare Advantage plans spend less on care, yet continue to cost taxpayers more than traditional Medicare. Coding is a major problem.
People who enroll in Medicare Advantage often can’t buy a Medigap plan if they later decide to switch to traditional Medicare. And others, especially retirees leaving their jobs, may not even realize their employers are enrolling them in Medicare Advantage.