The Medicare Advantage Program – How Can it Help Me?

If you are eligible for Medicare, you might want to look into Medicare Advantage programs as well. Formerly known as Medicare +Choice, Medicare Advantage is the private insurance option of Medicare. It offers participants the choice of using a private insurance plan instead of Medicare Supplement Plan G. Since Medicare’s for-fee services and restrictions can be significant, particularly in the case of prescriptions, providing people with this option allows many people to get better health insurance coverage with more benefits and lower out-of-pocket costs. And, because the cost of these plans is determined by competition among providers, you can often find an inexpensive plan that covers your needs, becoming an excellent alternative to Medicare itself.

Medicare Advantage (also known as Medicare Part C) allows you to sign up for a HMO or PPO plan…or Fee For Service (FFS) or a Medical Savings Account (MSA)…whatever fits your needs best. Or not. You are not forced to use a private insurer if you feel that Medicare’s coverage is adequate for your needs.

In the past, a Medicare Advantage plan also included the opportunity for much better prescription coverage. However, with the passage of the Medicare Part D prescription plan instituted in 2006, Medicare recipients now must sign up for a private prescription plan, even if they do not sign up for anything else but basic Medicare. However, should you opt for a Medicare Advantage plan, you will find that most companies offering such plans also offer Part D prescription plans.

Indeed, you might find it advantageous to get both because the additional cost may be minimal. However, be aware that, while Medicare Advantage plans are standardized, Part D prescription plans are not. So do not sign up for a joint plan automatically. Make sure your prescription plan meets your needs. There are no restrictions on having one plan with one company and the other with another company.

If you do not have medical problems, do not go to the doctor for more than an annual checkup, or otherwise rarely use medical services, a Medicare Advantage plan may not be for you. However, if you have a pre-existing condition, a Medicare Advantage plan may save you significant money in the long run by reducing out-of-pocket costs and because, except for end-stage kidney disease, preexisting conditions do not prevent you from enrolling, although you may need to choose a special needs plan.

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