What Are The Advantages And Disadvantages Of Medicare Advantage Plans?

What Is Medicare Advantage? 


Medicare Advantage (Part C) plans can offer you more than you would have with Original Medicare. Explore plan options and take time to consider your budget and your coverage needs to see what works best for you.

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Why Choose A Medicare Advantage Plan?


Medicare Advantage plans can offer more value than Original Medicare alone. With the right plan, you can save on costs for dental, vision, prescription drug coverage, and more. Because private insurers like Anthem offer Medicare Advantage plans, you also have more flexibility with your plan selection.



The Advantages Of A Medicare Advantage Plan


Most Medicare Advantage plans include benefits you may need that are not covered by Original Medicare, including:

  • Routine dental care, including X-rays, exams, and dentures

  • Vision care, including glasses and contacts

  • Hearing care, including testing and hearing aids

  • Prescription drug coverage

  • Wellness programs and fitness center membership, including SilverSneakers®.

Many Medicare Advantage plans feature low premiums (sometimes $0). Medicare Advantage plans also cap your maximum out-of-pocket expenses for Part C covered services. Once you reach the cap, you pay nothing for the rest of the year. Be sure to compare the Medicare Advantage plans’ costs along with coverage.



How Does Medicare Advantage Compare To Original Medicare?


Original Medicare includes Part A and Part B. Part A covers hospitalization, home care, and other inpatient medical needs. Part B covers only outpatient care, such as doctor visits, medical tests, screenings, and preventive care, which can be a disadvantage if you need more coverage. Medicare Advantage plans include Medicare Part A and Part B coverage, plus additional benefits like routine dental care, vision care, hearing care, and prescription drug coverage.



Medicare Advantage Plan Pros And Cons


There are many advantages to choosing a Medicare Advantage plan. In addition to benefits such as dental, vision, hearing, and prescription drug coverage, Medicare Advantage plans have low premiums — some as low as $0 per month. You’ll also have the convenience of having your benefits combined in one plan.


One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare. And if you sign up for a Medicare Advantage plan with an HMO network, you may need a referral from your primary care doctor to see a specialist. 



Questions To Ask While Comparing Medicare Advantage Plans


Finding the best Medicare Advantage plan may be worth it for the additional coverage. Be sure to ask the right questions to get the most out of the plan you pick. 

  • Are your preferred hospitals or preferred doctors included in the Medicare Advantage plan?
    Doctors and hospitals in a plan’s network can change yearly, so it’s best to make sure your family doctor is still in the plan after your initial enrollment. Just ask when you go for a doctor visit.

  • Which prescription drugs are covered?
    You can use our find a drug tool to see what drugs are available in the plan. If you need medications, are they available and affordable under a selected plan?

  • What is the maximum out-of-pocket amount?
    Medicare Advantage plans limit how much their members pay out of pocket for covered Medicare expenses. That amount varies depending on the plan you choose. After reaching the maximum out-of-pocket amount, Medicare Advantage plans pay 100% of eligible expenses. Choosing a plan with a lower out-of-pocket maximum may be preferable to make sure you have coverage for unexpected injuries or illnesses.


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Anthem Blue Cross is an HMO plan with a Medicare contract. Anthem Blue Cross Life and Health Insurance Company is an LPPO plan with a Medicare contract. Anthem Blue Cross is an HMO SNP plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company depends on contract renewal.