Medicare Advantage Plans 2023

Original Medicare Part C is what is commonly known as a Medicare Advantage Plan. It is a method in which people who have Medicare Part A and Part B can get those benefits via a private insurance company rather than the federal government.

Medicare Advantage Plans are offered by private insurance companies that have contracted with Medicare and are required to offer at least the same coverages that Medicare Part A and Part B offer.

Many seniors who are aging into Medicare question if it’s better for them to depend on Medicare or select a Medicare Advantage Plan. Certainly, there is a lot of information out there about Medicare Part A and Part B compared to coverages found in a Medicare Advantage plan, so it’s important that you consider the pros and cons that would apply specifically to you.

The Cost of Medicare Advantage versus Original Medicare

First of all, if you select a Medicare Advantage Plan in 2023 rather than staying with Original Medicare, you must continue to pay the Medicare Part B monthly premium. This means that your cost for a Medicare Advantage Plan is over and above the Part B premium.

However, depending upon your area of residence, there may be no additional premium charged for Medicare Advantage.

This means that some Medicare Advantage enrollees can get additional coverages not offered by Medicare Part A and Part B like dental, vision, and hearing, and pay no additional costs.

Additionally, your out-of-pocket expenses for deductibles, copays, and coinsurance could be significantly less than the out-of-pocket expenses that you’d have with Original Medicare.

To sweeten the deal, even more, Medicare Advantage Plans in 2023 contain a maximum annual out-of-pocket expense that policyholders will be responsible for. And, since Medicare Advantage insurance typically provides dental coverage, there would be no requirement to purchase Medicare Part D (prescription drug coverage).

Medicare Advantage plans will Coordinate Your healthcare Among Your Providers

Medicare Advantage is managed care and the insurance providers will use a network of health care providers (inpatient and outpatient). 

These networks are commonly referred to as HMO or PPO networks. When you enroll in a plan, you will select a primary physician that is a member of the network and will be coordinating your health care among all medical providers that you choose to deal with.

The network provider list typically contains all providers in your area who accept Medicare and have joined a network the insurance company relies on to provide healthcare services for its members.

Medicare Advantage Plans offer One-Stop Healthcare Services Coverage

If you are considering using only Medicare Part A and Part B, you will be getting fairly comprehensive coverage but you will need to purchase Part D for prescription drug coverage and continue to deal with the out-of-pocket expenses which result from copays, coinsurance, and deductibles.

Selecting a Medicare Advantage plan allows you access to dental, hearing, vision, and other benefits that you’ll not have with Original Medicare. Even if you select one of the best Medicare Supplement plans, these additional benefits must be purchased as stand-alone policies.

Moreover, depending on the company you choose to do business with, the industry competition has forced many Medicare Advantage plan providers to offer even more additional benefits like gym memberships, home health checkups, and transportation to and from your doctors’ offices.

Does Medicare Advantage Cover Pre-existing Conditions?

The short answer is Yes. 

When you sign up for Original Medicare Medicare cannot increase your rates or deny your coverage due to health conditions that you have now or have had in the past. This means that when you enroll in Medicare Advantage during an open enrollment period, your pre-existing conditions will not affect your rates or cause your application to be declined.

It’s important to note that even though you’ve decided to enroll in Plan C through a private insurance company, you’re still in the Medicare Program and have Medicare rights and protections.

If, however, there is a coverage gap between your Medicare Advantage plan and Medicare Supplement plan, your application to the new plan you are applying for may be subject to medical underwriting unless you can qualify for a special enrollment period.

What’s the Difference between Medicare Advantage and Medigap?

Medigap or Medicare Supplement insurance works alongside Original Medicare rather than as an alternative to it. A Medigap policy is sold as a way to fill the coverage gaps in Medicare which are a result of deductibles, copayments, and coinsurance. Medigap does not offer additional benefits like dental, hearing, and vision coverage.

For example, Medicare Part A which covers hospital charges has a per-day deductible of $176 during 2020 for the first 60 days of inpatient treatment. If you purchased a Medicare Supplement Plan (Medigap) this per-day deductible would be paid by the insurance company. 

Currently, there are ten standardized Medicare Supplement plans available in the U.S. starting with the most basic, Plan A, and becoming more comprehensive as you move up the list of available plans.

It’s important to note, however, Medicare Supplement plans do not offer dental, vision, or hearing benefits, but only supplement the Original Medicare Part A and Part B.

How do I know which Medicare Advantage Plan 2023 works Best for Me?

Seeing this as one of the most frequently asked regarding Medicare Advantage plans, let’s consider the questions you’ll need to ask yourself and share with your independent insurance professional. We recommend that interested applicants consider the following:

• Is your doctor a member of the plan’s network and if not, are you willing to change to one that is?
• If you are taking medications, check to see if the plan’s level of coverage for each one.
• Is the plan’s limit on out-of-pocket expenses competitive with other plans?
• Can your budget handle the additional insurance premium if there is no zero-premium plan available in your area?

The good news is that the competition within the senior healthcare industry has gotten to be pretty fierce resulting in an advantage to the consumer. But, to take advantage of the competitive marketplace, you should contact an independent insurance professional who represents many Medicare Advantage providers so that you can easily and quickly compare plans from each insurance plan.

An independent Medicare Advantage specialist does not work for the insurance companies they represent and can therefore put your needs first rather than an insurance company’s needs.