How to choose a medicare advantage plan

Published 11:42 am Friday, June 1, 2012

Dear Savvy Senior,
I’ll be 65 in a few months – Medicare enrollment age – and am interested in getting a Medicare Advantage plan to cover my health care and prescription drugs. Can you give me some advice on choosing a plan?
~ Searching Senior
Dear Searching,
Medicare Advantage plans have become increasingly popular among retirees over the past few years. In fact, around one-fourth of all Medicare recipients – nearly 13 million Americans – are currently enrolled in a Medicare Advantage plan. Here are some tips and tools to help you choose the best plan for you.
Medicare Advantage
Sometimes called Medicare Part C, Medicare Advantage plans are government approved health plans sold by private insurance companies that you can choose in place of original Medicare. The vast majority of Advantage plans are managed-care policies such as HMOs or PPOs that require you to get your care within a network of providers.
If you join an Advantage plan, the plan will provide all of your Part A (hospital insurance) and Part B (medical insurance) coverage – some plans even offer extra benefits like vision, dental and hearing. And, most plans include Part D prescription drug coverage too.
You also need to be aware that the monthly premiums for many Advantage plans are cheaper than if you got original Medicare, plus a separate Part D drug plan and a Medigap policy, but their deductibles and co-pays are usually higher. That makes these plans better suited for healthier retirees.
How to Choose
To help you choose a plan, a good first step is to call your doctors and find out which Advantage plans they accept, and which ones they recommend. Then go to the Medicare Plan Finder tool at www.medicare.gov/find-a-plan and compare those options. When comparing, here are some key points to consider:
Total costs: Look at the plan’s entire pricing package, not just the premiums and deductibles. Compare the out-of-pocket maximums plus the copays and coinsurance charged for doctor office visits, hospital stays, diagnostic tests, visits to specialists, prescription drugs and other medical services. This is very important because if you choose an Advantage plan, you’re not allowed to purchase a Medigap supplement policy, which means you’ll be responsible for paying these expenses out of your own pocket.

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