What does choosing Medicare Advantage mean for your health care costs?

What does choosing Medicare Advantage mean for your health care costs?

The costs may be different from what you pay with Original Medicare. These are some of the main differences. 

Cousins

After you choose a Medicare Advantage plan, you will continue to pay a monthly Part B premium to Medicare. And sometimes you will pay a premium to the company that provides the plan. But there are some Medicare Advantage plans that don't charge an additional premium.

Deductibles

Although Original Medicare has standard deductibles, these can vary from one Medicare Advantage plan to another. Also, with some plans, you will not have to pay any deductible.

copays

To see a doctor with Medicare Advantage, you may have to pay a lower copay (a set amount you pay for care) than you would under Original Medicare.

Firm limit on what you pay for health care

What if I need more medical attention due to an unforeseen event or illness? Medicare Advantage plans have a firm limit on how much you pay for covered health care each year. This means that once you have reached your yearly limit, you will not pay any additional costs for covered medical services. Original Medicare does not include this limit.

How do Medicare Advantage plans provide extra benefits at a reasonable price?

Medicare Advantage plans take advantage of the great efficiency of care networks. Networks are groups of doctors and other health professionals who are contracted with your plan. These help keep costs down. It also means that your care may not be covered if you receive services outside of your plan's network. So before you join, make sure your favorite doctors are in the plan's network.

It's also important to remember that not all plans are created equal. Two of the most common types are Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. 

What is the difference between an HMO plan and a PPO plan?

Medicare Advantage HMO plans generally require you to stay in the network. And you may need to get referrals to see specialists. However, there are some exceptions for emergency care or out-of-area urgent care. 

PPO Medicare Advantage plans generally have higher monthly premiums than HMO plans. But you have more flexibility to see doctors without a referral. In addition, you may be able to see health care providers outside of your plan's network. You will usually pay more if you do. 

Travel with Medicare Advantage

If you travel regularly, make sure you're covered in case you need care while traveling. Medicare Advantage plans generally have a service area, so certain plans are only available to people who live in certain areas. Also, networks of health care professionals may be restricted to the plan's geographic area, but there are exceptions.

Some Medicare Advantage plans focus on more than one region. So, there might be a plan for you even if you spend the summer in New England and the winter in Florida. Be sure to do some research to see if there are in-network doctors at both locations. Just because you travel regularly doesn't necessarily mean Medicare Advantage isn't for you.