How To Choose A Medicare Advantage Plan

How To Choose A Medicare Advantage Plan


Looking to boost your Medicare benefits? You may want to consider a Medicare Advantage plan.

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are provided by private companies that have been approved by Medicare. Medicare Advantage Plans must provide all of all of the services that Original Medicare covers except hospice care.

Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to the Medicare Part B premium, people typically pay a monthly premium for the Medicare Advantage Plan.

Open enrollment is open through December 7, so compare plans now to see if Medicare advantage fits your needs better than Original Medicare. You can also switch your current Medicare Advantage plan for another during the open enrollment period.

Finding Your Plan

Start by going to the Medicare Plan Finder on Choose the “General Search” option and enter your zip code. After gathering a bit of basic information, the search tool will ask you to enter your prescriptions. You can skip answering that question for now to get a broader view of the plans that are available to you.

After you’ve convinced the search tool that you really don’t want to enter your prescription information, you’ll see a screen with multiple filters (left hand side of screen). Begin by choosing the “Star Ratings.”

The new star rating system measures customer satisfaction with the plan, its benefits, and other critical issues. A plan’s star rating is granted by the Centers for Medicare & Medicaid Services. You can choose only to view plans with a particular star rating. You may wish to start by viewing 4 star and up plans available in your area.

Then, to compare plans, click on the plan’s name and then its benefits tab. Here you can see what a plan costs monthly (the premium), its deductible, and its copay and coinsurance amounts.

  • The plan’s deductible is the amount that you pay out of pocket for medical care before your insurance will begin to cover their portion of the costs.
  • The oopay is the predetermined rate you pay for health care services, payable when you get that care. For example, your plan may have a $30 copay for each doctor visit, and a $15 copay for prescriptions. The remaining cost of the service or medication is paid by your insurance.
  • Rather than copay, an insurance plan may use the coinsurance model. Rather than paying a flat fee for care, you pay a percentage of the cost of care. So, if your plan has a 20% coinsurance for doctors’ visits, you pay 20% of the doctor’s bill, your insurance pays the rest. Since fees for care can vary, obviously so can your coinsurance costs.

Check to see if the plan offers dental, hearing or vision benefits, by looking for the colored circles marked with D, H or V.

You may also want to look specifically for health maintenance organizations (HMOs) and preferred provider organizations (PPOs) plans.

With an HMO, you’ll need to select a primary doctor who coordinates your care, and will need to stay in network for your care to be covered. PPOs enable you to see any doctor, but you’ll pay less for care if you stay in network. HMOs cost less than PPOs.

Make sure that your doctor/s accept Medicaid Advantage plans, some don’t. And check to make sure that your doctors are included in the networks of the plans you are consdiering.  The easiest way to do this is to call your doctor, and ask if the plan or plans you are considering are accepted by the office.

The Final Cut

After you’ve done all this, jot down the plan names, click “Update Information” – that’s the button with the big blue letters on the left-hand side of your screen – and run your search again entering your drug names. If the plans that you selected appear on this list, you’ve successfully narrowed the field to just the plans that really fits your needs.

Selected your plan, and you’re almost done.  Does your plan offer dental insurance?

Dental Insurance And Medicare

If not, consider joining a dental savings plan. These plans are the affordable alternative to dental insurance, providing plan members with discounts on most dental services. As an example, most of the plans you’ll find on offer savings of 10%-60% at the dentist.

Dental savings plan members pay a low annual membership fee for access to an extensive network of participating dentists and dental specialists that provide discounts on dental care at the time of service. Since they are not dental insurance, dental savings plans do not have co-payments, deductibles, paperwork hassles or annual spending limits.

Many of the plans on offer additional “bonus” savings on health and wellness services such as vision and hearing care, discounts on prescription medications. Select plans offer savings on telemedicine, diagnostic tests, and fitness programs.

In addition, some dental savings plans offer discounts on some dental specialties that are rarely covered by dental insurance, including cosmetic dentistry services like veneers, teeth whitening, dental implants and more. So even if you have dental insurance, it may be worth joining a dental savings plan to get a discounted rate on specific services. Check with your dentist to correctly coordinate care between your insurance and your dental plan.



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