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Read About Several Potential Drawbacks of Medicare Advantage

doctor with paperwork

More than 55 million Americans are currently enrolled in Medicare. The huge

government health insurance program is available for seniors age 65 and older, and

it consists of four main parts:

• Part A, or hospital coverage.

• Part B, which covers medical services.

• Part C, also known as Medicare Advantage.

• Part D, prescription drug coverage.

Together, Part A and B are known as “Original Medicare,” because it’s what was

originally offered when the program was created under President Lyndon B.

Johnson in 1965.

Medicare Advantage, or Part C, is an alternative to the mentioned offering. It allows

for program enrollees to receive their Medicare benefits through a private health

insurance plan. The main benefit is that approved private insurance plans may be

able to offer more coverage options or more specific coverage to a certain health

care need than Original Medicare.

These offerings, however, do not automatically make the program better. Medicare

Advantage also comes with certain costs and coverage considerations that might

not be the best fit for many seniors.

At a minimum, every Medicare Advantage plan has to include Part A and B hospital

and medical coverage. While Part A is free, Part B includes an out-of-pocket

monthly premium of about $134 per month in 2018 based on the senior. Medicare

Advantage plans also come with premium costs, and the required Part B monthly

premium still applies. This can end up being quite expensive, especially for seniors

who are living on fixed incomes and can no longer work.

Moreover, some Medicare Advantage plans have high deductibles, not counting

prescription drug costs. Yet another drawback is that Medicare Advantage enrollees

are confined to their plan’s provider network, rather than having access to Part A and

B doctors and hospitals all over the country. Supplemental coverage, such as

Medigap, would provide additional coverage for items not included in a given Part C

plan, but is only available for Original Medicare enrollees.

While Medicare Advantage may be great for some, it simply isn’t a good fit for

others. The majority of all Medicare beneficiaries select Original Medicare, while

about a third opt for Medicare Advantage. The key is to research the right plan for

you based on your health needs. Medicare offers many resources to help you do

this. You can learn more on the Medicare website, including using the Medicare

tool to research plan benefits.

If Medicare Advantage is right for you, you can enroll during your initial seven-

month enrollment period beginning three months prior to your 65th birthday month,

during Medicare’s Annual Open Enrollment Period from October 15th to December

7th. Bear in mind that next year, Medicare Advantage enrollment period may be

changing and you can learn more here.

Do not wait to ask us your questions on Medicare or any issue facing you as a

Florida senior. We are here to support you and ensure that you have the education

and information you need both now and in the future.


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