Medicare Advantage has been very popular with a lot of seniors in 2011, but does it make sense for you? To answer that question, we need to look at what exactly Medicare Advantage plans do, and what changes have occurred in 2011 and in the future.
Medicare Advantage Plans Explained for 2011
Medicare Advantage plans are offered through private insurance companies and funded by the government. Because of the funding through the government, many of the Medicare Advantage plans have been able to offer ZERO premium plans in many areas of the country. These private insurers are paid large amounts of money each month to manage your health care for Medicare. This is why they are able to offer there programs at no premium. This also means that while you are on a Medicare Advantage plan Medicare does not pay your claims, the Advantage plan does. Example…when you go to the doctor the doctor files the claim with the Advantage plan not Medicare! You will pay your co-pay, and the plan pays the doctor the remainder. Most plans will operate as either an HMO or PPO, so you will need to determine if your doctor is in their network or files the insurance. See my post on Medicare Advantage HMO vs PPO for an explanation on these types of networks.
Changes to Medicare Advantage Plans in 2011
Medicare Advantage plans have to submit their Summary of Benefits to Medicare for approval on a yearly basis, and are valid for the calender year. Each year financial changes and competition cause the plans to adjust their coverage and costs accordingly. Many years ago many of the plans offered a lot of extra benefits such as gym memberships, dental, hearing, and vision care that Medicare did not offer. Even transportation was found in the majority of plans. By 2011 most of the extra benefits have been cut by the plans. Not all of the plans have cut all of these benefits, however; the best way to review the plans for your area, and what they offer is to check out www.medicare.gov. Most of the plans have kept the ZERO premium option in place, while cutting some benefits and increasing your co-pays. Expect 2012 to be even more dramatic.
Does Medicare Advantage Make Sense in 2011?
This is really a personal decision as each person has different needs and desires. Do you want the freedom to go wherever you want to go for your medical care? Is cost an issue? Are you healthy or not? All of these answers will give you direction on whether or not you should be looking at a Medicare Advantage Plan in 2011. Generally, if cost is an issue, you may have to consider a Medicare Advantage plan due to the cost of the alternative Medicare Supplement policies. If you don’t have a lot of doctors that you see, and they are in the HMO or PPO networks, you could save a lot of money by choosing the Medicare Advantage option!