How to select the best Medicare advantage plan for 2024
If you are eligible for Medicare, you may want to look into a Medicare Advantage plan. Medicare Advantage, also referred to as ‘Medicare Part C’ offers persons who are eligible for Medicare the choice of insuring their medical needs by means of a private insurance instead of original Medicare itself.
While Medicare was designed to cover basic health care needs much like a ‘safety net’, it will only pay 80% of your ‘approved’ medical expenses, and doesn’t even cover services such as vision, dental or hearing aids. Only relying on Medicare, you will also have deductibles, co-pays and co-insurance for most services.
This is why ‘replacing’ your traditional Medicare plans with a Medicare Advantage plan is a great investment in your health. Currently, nearly 50 % of seniors eligible for Medicare have preferred advantage plans. These Medicare health plans offered by private insurers provide better coverage and additional benefits at an affordable or sometimes even zero premium over what you pay for your Part B.
The insurance market is very competitive when it comes to Medicare advantage, and government approved insurance providers add new attractive plans each year. If you take the time to shop around, you may very well increase your medical benefits by saving a significant amount of your health care costs.
How to compare Medicare Advantage plans?
Your first step to compare plans should be to make a personal ‘checklist’ with all health care services, medical equipment and prescription drugs you currently need. As your medical needs may change in the future, please make a note to review your insurance coverage each year during the open enrollment period from October 15 through December 7.
Now it’s time to find out which Medicare advantage plans are available to you. This depends on where you live. In bigger cities you may have a number of choices, while your options in rural areas are usually limited. The online Plan Finder tool at Medicare.gov is a great starting point.
What to look for when shopping for the best Medicare Advantage plan
1 to 5 stars ratings
Advantage plans are rated from 1 to 5 stars by CMS, the Centers for Medicare & Medicaid Services. By using information from different sources such as member satisfaction surveys, these ratings will help you better compare plans, based on quality and performance. These ratings are updated each year before the new open enrollment period starts.
Benefits, drug coverage and restrictions
Once you have preselected some plans, continue to compare each plan’s benefits with your checklist. While each Medicare advantage plan must include Part A (Hospital) and Part B (Outpatient) benefits, many offer additional benefits which may include prescription drug coverage, health programs and fitness club memberships, and many other features. Compare coverage and restrictions for the health care services and prescription drugs you use.
Most advantage plans have their own network of participating doctors, hospitals and pharmacies that you are required to use. Any service you seek from outside the plan’s network is not covered! So if your health care provider is not inside a particular plan’s network, you may have to change the doctor or the plan – or you will be doomed to pay out of your own pocket.
Premiums, Deductibles, Co-Payments, Out-Of-Pocket Maximum
When you compare costs of different advantage plans, keep in mind that there may be deductibles and co-payments on top of your monthly premiums. Are the plan’s total annual costs affordable for you, even in case an unforeseen illness must be treated? Make sure to check out the annual maximum out-of-pocket amount as well. The maximum out-of-pocket amount is what makes advantage plans superior to original Medicare: After you have met your maximum out-of-pocket amount during the year, the insurer pays 100% of all covered expenses.
By now, you should have a good idea, which plan best covers your individual needs for health care services and prescription drugs.
If you still have unanswered questions after doing your own research and comparison, you can also call Medicare at 1-800-MEDICARE, or ask a licensed insurance broker specializing in Medicare in your area.
