Medicare Advantage Coverage and Enrollment Periods

Medicare Advantage is a cost-saving option for many seniors to cover out-of-pocket expenses associated with Medicare. These plans include many additional benefits that Medicare does not. Putting together similar coverage using Part A and B would require adding a Part D plan to be comparable.

Individuals receive Part A and B coverage from an insurance company, not Medicare. In exchange, the government makes payments to them to cover the cost. Insurance companies negotiate with local hospitals and doctors for reduced rates. Unlike Medicare, you will be required to use this specific network of providers with these plans.

Individuals continue to receive Medicare Part A and B coverage, as well as additional benefits not provided by Medicare. Most plans include benefits for prescriptions, dental, vision, fitness programs, and even hearing. Plans use a network of providers, and as a member, you agree to use the hospitals, doctors, and pharmacies in the service area. You can use providers who are not, but it will cost you more. It’s important to review your plan’s network requirements, If you don’t, you may be responsible for the total costs of services.

There are several different Medicare Advantage Plans to choose from, with varying premium amounts. Many companies offer $0 premium plans with additional benefits. Plans with no premium may be a cost-effective option, but they do have expenses like deductibles, and copays. The co-payment is in place of the 20 percent coinsurance you would pay under Medicare. Plans are required by law to put a maximum amount you will spend out-of-pocket for deductibles and copays each year.

Does the plan provide extra benefits (prescription, vision, dental)?

What is the cost for each doctor visit (copayment, coinsurance)?