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How do you find the best Medicare Advantage plan option? Medicare is national but Medicare Advantage plans are local. Most seniors today have 25 to 50 different Advantage plans to choose from. Comparing can get you better plan coverage. It can save you money. Here’s what to look for:
A local Medicare insurance professional should know the pros and cons of different plans available in your area.
What plans do others (your neighbors) complain about?
Which plans are people joining and then switching from?
How do local health care providers really treat patients like you?
Every year about 10% of all Medicare Advantage plan participants switch plans. They do so because they are unhappy. Or to get better benefits, services and to save money.
A local independent Medicare insurance agent can help you compare. Speaking with one should be part of your research.
Look for agents on the Association’s directory that say they offer Medicare Advantage information.
There are five types of Medicare Advantage plans:
Health maintenance organization (HMO plans): These require use of an in-network provider. Emergency situations are exempt. Most require a referral to see a specialist.
Preferred provider organization (PPO plans): A greater flexibility. You can generally see both in-network and out-of-network health care providers. Read details because it is typically more expensive to go out of network. PPOs are generally local. Some may expand to a wider regional area.
Private fee-for-service (PFFS plans): These allow you to see any Medicare-approved health care provider as long as they accept the plan’s payment terms and agree to see you. There may be a network of providers. And, you may be able to see doctors that don’t accept the plan’s payment terms. Be prepared to pay more.
Special needs plans (SNPs): For Medicare beneficiaries who are either dually eligible for Medicare and Medicaid. SNPs require an institutional level of care or have certain chronic or disabling conditions. These can include diabetes, chronic heart failure or dementia.
Medical savings account (MSA plans): MSAs combine a high-deductible insurance plan with a medical savings account. Understand that dollars can be specifically used for health care costs.
CON: Less choice. You may not have complete freedom to choose your medical providers.
CON: Significant out-of-pocket costs.
More plans are including dental benefits. That sounds great in the 30-second television ad. But the plans can vary significantly. Learn more about Medicare Advantage dental benefits. What to look for. Questions to ask.
Seniors on Social Security can benefit from the Medicare Advantage Give Back Benefit. Read how it works and how it may benefit you.