
Are Most People Happy with Their Medicare Advantage Plan?
Medicare Advantage Plans are a popular alternative to traditional Medicare for many beneficiaries. They offer the same benefits as Original Medicare, plus some extra perks like dental, vision, and prescription drug coverage. But are most people satisfied with their Medicare Advantage Plan? And what are the pros and cons of choosing this option over traditional Medicare?
What is a Medicare Advantage Plan?
A Medicare Advantage Plan is a type of health insurance plan that is offered by private companies that contract with Medicare. These plans provide all the benefits of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and usually include Medicare Part D (prescription drug coverage) as well. Some plans may also offer additional benefits, such as dental, vision, hearing, wellness, and fitness programs.
Medicare Advantage Plans are also known as Part C or MA plans. They are one of the two ways to get your Medicare coverage, the other being Original Medicare. Original Medicare is the traditional fee-for-service program that pays for most of your health care services, but does not cover everything. You may have to pay deductibles, coinsurance, and copayments for some services, and you may need to buy a separate Medigap policy to help pay for some of the gaps in Original Medicare. You may also need to enroll in a stand-alone Part D Plan to get prescription drug coverage.
Medicare Advantage Plans, on the other hand, are designed to provide all-in-one coverage that includes everything that Original Medicare covers, plus more. You usually pay a monthly premium for your plan, in addition to your Part B premium, and you may have to pay copayments or coinsurance for some services. However, you do not need to buy a Medigap policy or a Part D Plan, as these are already included in your Medicare Advantage Plan. You also have an annual limit on your out-of-pocket costs, which means that once you reach a certain amount, you do not have to pay anything more for covered services for the rest of the year.
How Many People Are Enrolled in Medicare Advantage Plans?
According to the Kaiser Family Foundation, nearly half of all Medicare beneficiaries (49%) were enrolled in Medicare Advantage Plans as of February 2021. This represents a significant increase from 2006, when only 16% of beneficiaries were enrolled in these plans. The growth in enrollment has been driven by several factors, such as:
· The availability and affordability of Medicare Advantage Plans. There are more than 4,800 plans available nationwide in 2021, and most beneficiaries have access to at least 20 plans in their area. The average monthly premium for a Medicare Advantage Plan in 2021 is $21, which is lower than the average premium for a Part D Plan ($42).
· The attractiveness and convenience of Medicare Advantage Plans. Many beneficiaries choose Medicare Advantage Plans because they offer extra benefits that Original Medicare does not cover, such as dental, vision, and hearing care. Some plans also offer perks like gym memberships, transportation services, and over-the-counter drug allowances. Additionally, many beneficiaries appreciate the simplicity and ease of having one plan that covers all their health care needs, rather than having to deal with multiple plans and providers.
· The quality and performance of Medicare Advantage Plans. Most Medicare Advantage Plans are rated by the Centers for Medicare & Medicaid Services (CMS) based on how well they provide care and service to their members. The ratings range from one to five stars, with five being the highest. In 2021, more than half of all Medicare Advantage enrollees (56%) were in plans that received four or more stars, which means that they met or exceeded CMS’s standards for quality and performance.
Are Most People Satisfied with Their Medicare Advantage Plan?
According to several surveys and studies, most people who are enrolled in Medicare Advantage Plans are satisfied with their coverage and experience. For example:
· A survey conducted by Morning Consult in 2019 found that 93% of Medicare Advantage enrollees were satisfied with their plan, compared to 84% of traditional Medicare beneficiaries.
· A study published by Health Affairs in 2019 found that Medicare Advantage enrollees reported higher satisfaction with their health care quality and access than traditional Medicare beneficiaries. They also reported lower rates of problems with care coordination, provider communication, and medical errors.
· A report by America’s Health Insurance Plans (AHIP) in 2018 found that 90% of Medicare Advantage enrollees were happy with their health plan’s overall performance, and 91% were happy with their plan’s customer service.
These findings suggest that most people who choose Medicare Advantage Plans are happy with their decision and enjoy the benefits and services that these plans offer. However, this does not mean that Medicare Advantage Plans are perfect or that they suit everyone’s needs and preferences. There are also some drawbacks and challenges that Medicare Advantage enrollees may face, such as:
What are the Pros and Cons of Medicare Advantage Coverage?
Like any health insurance option, Medicare Advantage Plans have their advantages and disadvantages. Here are some of the main pros and cons of choosing a Medicare Advantage Plan over Original Medicare:
Pros of Medicare Advantage Plans
· Lower and more predictable costs. Medicare Advantage Plans have an annual limit on your out-of-pocket expenses, which means that you do not have to worry about paying too much for your health care in a given year. You also do not have to buy a separate Medigap policy or a Part D Plan, which can save you money on premiums and deductibles. Additionally, some Medicare Advantage Plans have zero or low monthly premiums, which can make them more affordable than Original Medicare.
· More comprehensive and convenient coverage. Medicare Advantage Plans cover everything that Original Medicare covers, plus more. You can get dental, vision, hearing, and prescription drug coverage in one plan, rather than having to enroll in multiple plans or pay out-of-pocket for these services. Some plans also offer extra benefits that can improve your health and well-being, such as wellness programs, fitness classes, telehealth services, and home health care. Furthermore, you only have to deal with one plan and one card, which can make your health care experience simpler and easier.
· Better quality and performance. Medicare Advantage Plans are rated by CMS based on how well they provide care and service to their members. You can use these ratings to compare and choose a plan that meets your standards and expectations. Most Medicare Advantage Plans are rated highly by CMS, which means that they deliver high-quality care and service to their enrollees. Some plans also offer incentives and rewards for staying healthy and following your doctor’s recommendations, such as reduced copayments or gift cards.
Cons of Medicare Advantage Plans
· Limited choice and flexibility. Medicare Advantage Plans have networks of doctors, hospitals, and other providers that they contract with to provide care to their members. You may have to pay more or get prior authorization if you want to see a provider who is not in your plan’s network. You may also have to follow your plan’s rules and procedures for getting referrals, tests, treatments, and prescriptions. This can limit your choice and flexibility in choosing where, when, and how you receive your health care services.
· Potential changes and disruptions. Medicare Advantage Plans can change their benefits, costs, networks, and rules every year. You may have to review your plan’s information carefully during the annual enrollment period (October 15 to December 7) to make sure that it still meets your needs and preferences. You may also have to switch plans or providers if your current plan is discontinued or if your provider leaves your plan’s network. This can cause inconvenience and disruption in your health care continuity and quality.
· Less access to specialized care. Medicare Advantage Plans may have fewer providers who are specialists or who offer specialized services than Original Medicare. This can make it harder for you to access the care you need if you have a complex or rare condition that requires specialized expertise or equipment. You may also have to wait longer or travel farther to see a specialist who is in your plan’s network or who accepts your plan.
How to Choose the Best Medicare Advantage Plan for You
If you are interested in enrolling in a Medicare Advantage Plan, you should consider several factors before making a decision. These include:
· Your health care needs and preferences. Think about what kind of health care services you use or expect to use in the future, such as preventive care, primary care, specialty care, hospital care, prescription drugs, dental care, vision care, hearing care, etc. Also think about how often you use these services, how much you are willing to pay for them, and how satisfied you are with the quality and access of these services.
· Your budget and financial situation. Think about how much you can afford to pay for your health insurance each month and each year. Consider the premiums, deductibles, copayments, coinsurance, and out-of-pocket limits of each plan that you are comparing. Also consider the potential savings or costs of having extra benefits or services that are not covered by Original Medicare.
· Your location and travel plans. Think about where you live and where you want to receive your health care services. Consider the availability and accessibility of providers who are in your plan’s network or who accept your plan in your area. Also consider whether you travel frequently or plan to travel in the future, either within the U.S. or abroad. Some plans may not cover you outside of their service area or outside of the country.
· Your personal preferences and values. Think about what matters most to you when it comes to your health
We’re Here to Help
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Bourgeois Insurance a Call at (985) 803-8999. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.
FAQ
What is Medicare Advantage?
Medicare Advantage is an alternative to traditional Medicare run by private insurers under Medicare. Plans may include Medicare Part A, B and often Part D prescription drug coverage.
What is the difference between Medicare Advantage and Medigap?
Medigap is a Medicare supplement insurance plan to help cover costs that traditional Medicare doesn't. Medicare Advantage Plans are run by private insurers and provide full (Part A/B/D) coverage through one insurance plan.
What can a Medicare Advantage Plan cover?
Many plans include Medicare Part A/B benefits and often prescription drug coverage. Some plans may also cover dental, vision and fitness benefits not covered under regular Medicare.
How do people choose between Medicare options?
Consider your budget, health needs and which doctors and hospitals are in your preferred plan’s network when deciding between Original Medicare plus a Medigap Plan or Medicare Advantage. Use the Medicare Plan Finder for tailored options.
Can you switch between Medicare options?
You can generally switch between Medicare Advantage and Original Medicare during the fall Open Enrollment period each year. You may also switch to a different Medicare Advantage Plan during this period.