How to Select the Best Medicare Advantage Plan

Before identifying the best Medicare Advantage Plan for you, it’s important to understand the difference between “Original” Medicare versus Medicare Advantage.

Medicare Advantage is a Medicare-approved plan from a private company and is an alternative way to get Original Medicare Part A (inpatient hospital insurance) and Part B (outpatient medical insurance). Medicare Advantage Plans (Part C) also typically include Medicare drug coverage (Part D).

For more on what the Medicare letters mean, check out our post, The ABCs of Medicare.

Medicare Advantage vs. Medicare

According to Medicare.gov, “Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare (Parts A and B) for your health and drug coverage. These ‘bundled’ plans include Part A, Part B, and usually Part D. In most cases, you can only use doctors who are in the plan’s network.”

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Why Choose a Medicare Advantage Plan Over Original Medicare?

The short answer—you may receive coverage for things conventional Medicare doesn’t cover, like routine vision, hearing or dental services.

Tip: Watch out for these 5 Medicare enrollment mistakes.

2 Key Considerations 

1. Costs

Managing health care costs is an important retirement planning consideration.

Understanding your share of the costs for services and supplies, therefore, is critical. Coinsurance, copayments and deductibles add up. Ultimately, you’ll want to find a balance between coverage and cost.

For 2022, Original Medicare Part A can cost as much as $499 per month (if you don’t qualify for Social Security), and Part B as much as $578 per month. Part B costs are based on your modified adjusted gross income.

Tip: For detailed information regarding Medicare costs and enrollment deadlines, download our complimentary special report, Medicare Made Simple.

Keep in mind, when you purchase a Medicare Advantage Plan, you still have Original Medicare coverage; however, most of your Part A and Part B are covered by your Medicare Advantage Plan.

You’re also responsible for paying your Original Medicare Part B monthly premium.

2. Doctors and Specialists

The best Medicare Advantage Plans include your favorite doctors and medical specialists.

Therefore, before making a final plan selection, ensure your doctors are part of the plan’s network. If you need to select a new doctor, confirm that they’re accepting new patients.

Also consider where your doctors and pharmacy are. Are the locations convenient? Some Medicare Advantage Plans will pay for transportation to approved medical facilities, but there are restrictions.

One key distinction between Medicare and Medicare Advantage Plans is the latter often requires a referral before you can see a specialist or a preapproval for medical supplies. Ultimately, Medicare Advantage Plans must cover all medically necessary services that Original Medicare covers.

Tip: If you’re planning an early retirement and are not yet age 65, check out these five alternative health care options to bridge the gap.

Important Exception

Both Original Medicare and Medicare Advantage Plans generally don’t provide medical coverage outside the U.S. Therefore, if you’re anticipating global travel, it’s a good idea to purchase supplemental medical insurance.

There are a few situations when Medicare may cover your foreign country medical expenses.

For Example:

You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists, according to Medicare.

If your foreign medical care is covered, you’ll likely need to submit an itemized bill to Medicare since foreign hospitals aren’t required to file Medicare claims on your behalf.

Next Steps

When making your final selection, keep in mind out-of-pocket costs (they can add up) and what doctors and specialists are in the plan’s network.

For more information, check out our other resources, including:

Answers to Popular Medicare Coverage Questions

Fine-Tuning Your Medicare Coverage

Medicare Made Simple (podcast)

Want help navigating Medicare’s complexities? Contact Adviser Investments anytime for assistance. We pride ourselves on being The Planner You Can Talk To.