Why do people want Medicare Advantage?

Asked by: Dr. Beulah Parker  |  Last update: January 2, 2024
Score: 4.4/5 (30 votes)

Many Medicare Advantage plans offer additional benefits, such as money toward dental or vision care, which isn't covered by original Medicare. About 1 in 4 people say extra benefits pushed them to choose Medicare Advantage, according to a survey by the Commonwealth Fund, a health care think tank.

Why would someone choose Medicare Advantage?

With a Medicare Advantage Plan, you may have coverage for things Original Medicare doesn't cover, like fitness programs (gym memberships or discounts) and some vision, hearing, and dental services (like routine check ups or cleanings).

Why would I choose Medicare Advantage over Original Medicare?

Original Medicare does not include prescription drug coverage. You may choose to purchase a stand-alone prescription drug plan from a private company. Most Medicare Advantage plans include coverage for prescription drugs, although there are also MA plans that cover medical services only.

Is Medicare Advantage better or worse?

For many seniors, Medicare Advantage plans can work well. A 2021 study in the Journal of the American Medical Association found that Advantage enrollees often receive more preventive care than those in traditional Medicare. But if you have chronic conditions or significant health needs, you may want to think twice.

Can you go back to Medicare from an Advantage plan?

If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare Part A & Part B.

Why Medicare Advantage Is The Worst Choice For Seniors

15 related questions found

Do most people have Medicare Advantage?

As of January 2023, 48 percent of all Medicare beneficiaries are enrolled in Medicare Advantage, translating to 30.7 million people.

Is Medicare Advantage cost effective?

Medicare Advantage can cost less than Original Medicare. That's because Medicare Advantage plans must have a maximum out-of-pocket limit. In 2023, the maximum for in-network services will be $8,300 and, for in- and out-of-network combined, $12,450. (The limits this year are $7,550 and $11,300.)

What percentage of people choose Medicare Advantage?

More than 28 million Medicare beneficiaries – 48 percent of all eligible beneficiaries – are enrolled in Medicare Advantage plans, which are mostly HMOs and PPOs offered by private insurers.

Who is the best candidate for a Medicare Advantage plan?

The Medicare Advantage plan may offer a $0 premium, but the out-of-pocket surprises may not be worth those initial savings if you get sick. “The best candidate for Medicare Advantage is someone who's healthy,” says Mary Ashkar, senior attorney for the Center for Medicare Advocacy.

Do most people have Medigap or Medicare Advantage?

Nine in 10 people with Medicare either had traditional Medicare along with some type of supplemental coverage (51%), including Medigap, employer-sponsored insurance, and Medicaid, or were enrolled in Medicare Advantage (39%) in 2018 (Figure 1).

Do more people have Medicare or Medicare Advantage?

In 2022, more than 28 million people are enrolled in a Medicare Advantage plan, accounting for nearly half or 48 percent of the eligible Medicare population, and $427 billion (or 55%) of total federal Medicare spending (net of premiums).

Who dominates Medicare Advantage market?

MA Leading Plan Performance

There are 294 insurers covering the MA marketplace in the United States, however nearly 80 percent of MA enrollees selected one of only 10 insurers. As of March 2023, UnitedHealth continues to dominate in this highly competitive segment.

Why do so many older adults choose Medicare Advantage?

Many Medicare Advantage plans offer additional benefits, such as money toward dental or vision care, which isn't covered by original Medicare. About 1 in 4 people say extra benefits pushed them to choose Medicare Advantage, according to a survey by the Commonwealth Fund, a health care think tank.

Can Medicare Advantage plans pay less than traditional Medicare pays?

After accounting for differences in hospital networks, geographic areas, and case-mix between Medicare Advantage and FFS Medicare, we found that Medicare Advantage plans paid 5.6 percent less for hospital services than FFS Medicare did.

What is the difference between Medicare Original and Medicare Advantage?

Medicare Advantage: Coverage. Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).

Are Medicare Advantage plans becoming more popular?

A Record 30.7 Million Individuals Are Now Enrolled in Medicare Advantage. Penetration continues to grow, with 48% of all Medicare beneficiaries now enrolled in a Medicare Advantage product. This reflects growth of 2.7 million total beneficiaries since 2022.

Can you go back to original Medicare after Medicare Advantage?

If you're already in a Medicare Advantage plan and you want to switch to traditional Medicare, you should contact your current plan to cancel your enrollment and call 1-800-MEDICARE (1-800-633-4227). Note there are specific enrollment periods each year to do this.

Can you cancel a Medicare Advantage plan at any time?

If you're in a Medicare Advantage plan with or without Part D coverage, you can: Switch to another Medicare Advantage plan with or without Part D coverage, OR. Disenroll from your plan and return to Original Medicare anytime between January 1 – March 31.

What costs count toward the out of pocket maximum for Medicare Advantage MA plans?

The out-of-pocket costs that help you reach your MOOP include all cost-sharing (deductibles, coinsurance, and copayments) for Part A and Part B covered services that you receive from in-network providers. Part D cost-sharing does not count towards your plan's MOOP.

What percentage of seniors use Medicare Advantage plans?

Touting Medicare Advantage plans, these campaigns promise low premiums and all kinds of extra benefits. And they work. The proportion of eligible Medicare beneficiaries enrolled in Medicare Advantage plans, funded with federal dollars but offered through private insurance companies, has hit 48 percent.

Why are there so many Medicare Advantage commercials?

Two features of Advantage plans make them easy to advertise: the additional benefits and monthly premiums as low as zero dollars in some counties. Original Medicare doesn't include dental, vision or hearing coverage, whereas Advantage plans often do.

How do Medicare Advantage plans compete?

Some Medicare Advantage plans compete for enrollees by offering a lower-than-required cap on out-of-pocket expenses for doctor and hospital services. In 2021, the average out-of-pocket limit was $5,091 for in-network services. Traditional Medicare has no out-of-pocket maximum for doctor or hospital service costs.

Why switch from Medigap to Medicare Advantage?

Medigap provides a larger network but is often pricier than many Medicare Advantage plan premiums. If you are in relatively good health and are not concerned with hereditary health conditions that could develop, then switching to a Medicare Advantage plan could significantly lower your monthly healthcare expenses.

Why Medigap instead of Medicare Advantage?

The biggest difference between Medigap and Medicare Advantage is that with a Medigap plan, you have the freedom to see any doctor that accepts Medicare, whereas with Medicare Advantage, you must get care within the plan's network of doctors and hospitals unless it's an urgent or emergency situation.