Medicare’s open enrollment period runs from Oct. 15 through Dec. 7. Sometimes called “Part C,” Medicare Advantage plans are offered by Medicare-approved private companies.
More than 28 million people are enrolled in the Advantage plans, according to a data analysis from the Kaiser Family Foundation.
Figure out your options
The decision you make when you become eligible at age 65 could have significant health and financial consequences down the line.
Original Medicare includes Part A, which covers hospital care, and Part B for outpatient care. Part D exists for prescription drugs. Consumers can fill in gaps in their desired coverage with supplemental coverage, known as Medigap.
Part C, the Advantage plans, usually come as a bundle of A, B, and D, and may offer extra benefits such as vision, hearing, and dental coverage.
Do the math
Many applicants are drawn to Medicare Advantage by the promise of overall low premiums and out-of-pocket expense caps. However, the plans often have higher deductibles and copayments. Medicare Part D and Medigap plans often have higher premiums than Advantage plans but cover more healthcare services.
Understanding the limitations of your coverage
The majority of Medicare Advantage plans are HMOs, which have a restricted network of doctors, hospitals, and health providers, and offer less flexibility than PPO plans, which offer access to out-of-network providers at higher costs.
Medicare Advantage plans often require patients to obtain a referral to see a specialist, as well as prior authorization for certain drugs or services, which generally isn’t required with traditional Medicare.
If you decide to go with Medicare Advantage, be sure to ask the provider or independent agent with whom you are working whether your doctors and prescriptions are within the network’s coverage. Be aware that coverage can change from year to year.
