Choosing the best Medicare Advantage Plan for your needs can be challenging with all the different plan options available. Here is a detailed guide on how to pick the optimal Medicare Advantage Plan in 2023.
Understand the Basics of Medicare Advantage
Medicare Advantage, also known as Medicare Part C, allows private health insurance companies to provide Medicare benefits. Medicare Advantage Plans include all coverage offered under Parts A and B. Many plans also include prescription drug coverage under Part D Drug Plan.
Medicare Advantage Plans offer lower out-of-pocket costs than Original Medicare and provide extra benefits Original Medicare doesn't cover, like dental and vision care. Instead of Original Medicare's fee-for-service structure, most Medicare Advantage Plans use provider networks and require you to see in-network doctors to get the highest level of coverage.
There are several types of Medicare Advantage Plans:
Compare Medicare Advantage Plans in Your Area
All Medicare beneficiaries can enroll in a Medicare Advantage Plan during open enrollment from October 15 to December 7 each year for coverage starting January 1. Medicare Advantage Plans available vary based on your zip code. You can compare plans side-by-side on Medicare.gov or the plan finder tool.
When comparing many Medicare Advantage Plans, look at:
Medicare has a plan finder tool on their website that lets you enter your medications and preferred providers to find compatible plans. This can help narrow options.
Consider Your Health Needs Choosing a Medicare Coverage
Think about your health status and needs for the upcoming year when choosing a Medicare Plan.
Determine which benefits are must-haves versus nice-to-haves when assessing plans. Prioritize the plan features most important to your health needs.
Double Check Provider Networks
With Medicare Advantage Plans, you will usually pay much more to see out-of-network providers, if they are covered at all.
Before enrolling in a plan, verify that your preferred doctors, hospitals, specialists, pharmacies and other providers are in-network. Some key steps include:
Weigh Total Costs
While premiums are important, also consider the full costs you will incur under each plan based on your expected medical services.
Estimate your total costs including:
Some plans have $0 or low premiums but charge more when you need care. Other plans have higher premiums but lower cost-sharing when you use services. Run the numbers based on your anticipated healthcare utilization.
Medicare Advantage Plans must have annual limits on your out-of-pocket spending for covered medical services. Original Medicare does not have an out-of-pocket cap.
Consider Add-On Coverage
Some people enroll in a Medicare Advantage Plan and additionally buy a Medicare Supplement (Medigap) Plan or separate Part D prescription coverage. This can reduce out-of-pocket costs but increases your monthly premium expenses.
You cannot use a Medicare Supplement to pay for copays, deductibles and other costs under your Medicare Advantage Plan. The supplement can only cover Original Medicare expenses. You may want to compare costs of Medicare Advantage alone versus original Medicare Plus a Supplement Plan.
You can enroll in a stand-alone Part D Prescription Plan with most Medicare Advantage Plans to supplement the Advantage drug coverage. This can provide savings if the Part D Plan covers medications your Advantage Plan does not include, preferred pharmacies have lower costs under the Part D Plan, or you reach the coverage gap (donut hole).
Pick a Plan
Once you have researched plans, costs and coverage options, select the Medicare Advantage Plan that best fits your healthcare needs and budget. Key factors in choosing a plan include:
The optimal Medicare Advantage Plan provides comprehensive coverage you can afford to use that includes the providers and benefits most essential for your personal health profile and needs.
Enroll During Open Enrollment
You can join or switch Medicare Advantage Plans during the Medicare open enrollment period from October 15 to December 7 each year. Your coverage under the new plan will begin January 1.
If you are switching from Original Medicare to a Medicare Advantage Plan, your Original Medicare benefits will end when your new Advantage Plan coverage starts. Make sure to enroll in time to avoid any gap in coverage.
Medicare Advantage open enrollment happens once a year, but there are some exceptions allowing you to switch plans mid-year:
Research new plans annually and be ready to switch if another Medicare Advantage Plan becomes the optimal choice based on changes in your healthcare needs, new plan options, and comparative costs.
Choosing the best Medicare Advantage Plan involves:
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 The Insurance Space a Call at (866) 717-8683. 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.