Pros and Cons of Private Medicare Advantage Plans
Who should take advantage of these all-in-one senior health care plans?
By Kimberly Lankford, Contributing Editor
From Kiplinger's Personal Finance magazine, March 2008
- Comments
- Email This Article
- Print This Article
- Order a Reprint
Advertisement
Private Medicare Advantage plans can be a good deal for seniors looking for all-in-one medical and drug coverage. There are three types of policies -- Medicare HMOs, which charge the lowest premiums but impose the most restrictions on which doctors and hospitals you can use; regional preferred-provider organizations, which offer discounts if you use in-network doctors and hospitals; and private fee-for-service plans, which let you use any doctor or hospital that accepts the plan’s terms.
Medicare Advantage plans may charge lower premiums than you’d pay for Medicare plus a medigap policy and Part D prescription-drug coverage. But you could end up paying higher out-of-pocket costs throughout the year.
Some Medicare Advantage plans charge higher co-payments for big-ticket items such as hospitalization, or for critical services such as chemotherapy. Or they might not pay for the first 20 days in a skilled-nursing facility (which traditional Medicare covers). In addition, a plan may provide limited coverage if you travel out of state.
Instead of simply responding to a sales pitch from an insurance agent or to an ad, check all of the Medicare options in your area. Compare plans using the Medicare Options Compare tool at Medicare.gov/mppf, looking at both premiums and total estimated costs for people like yourself.
RELATED LINKS | |||
 |
How to Spot a Health Care Scam | ||
|
|
Health Care Shock in Retirement | ||
- Comments
- RSS
Permission to post your comment is assumed when you submit it. The name you provide will be used to identify your post, and NOT your e-mail address. We reserve the right to excerpt or edit any posted comments for clarity, appropriateness, civility, and relevance to the topic.
View our full privacy policy
Reader Comments (3)
Posted by: Vernon Wilmer at 01/24/2008 12:30:22 PM
"Private Medicare Advantage plans can be a good deal for seniors looking for all-in-one medical and drug coverage". This is not true for seniors living on fixed incomes. I just finished getting my mother back on regular Medicare after she learned thru experience she could not afford these "advantages". This article also suggests several ways seniors can check out these plans online, to a senior population that is largely computer challenged and has difficulty reading the fine print. These plans are marketed with no clear statements about replacing Medicare with their plan or that costs may be higher or that the medigap insurance coverage doesn't work with these plans.
Posted by: Janie at 01/31/2008 08:35:46 AM
I wish your article on Medicare Advantage- Fee for Service Plans was published a month earlier. I have just been made aware that my husband (is) suffering from early signs of dementia...I am currently trying to get him back on traditional medicare. Thanks for suggesting help for this situation...
Posted by: Suzie at 11/28/2009 04:56:37 AM
askkim@kiplinger.com. Beginning Medicare this year, I find this entire “mass marketing” of Medicare Advantage to be a waste of the taxpayer’s money as well as truly deceiving to recipients. I consider this issue as bad as all of the credit card shenanigans now being addressed in Washington considering the government subsidizes these insurance companies with 14% more than standard Medicare rates. Daily via USPO mail, I receive multiple solicitations advertising “if you’re paying more than $0 for your coverage, you’ll want to get this Free Information right away”. • 63 days in the hospital could cost you $1,925 with Medicare alone! • Go to hospital, doctor, outpatient skilled nursing facility, you pay $0 What these companies fail to reveal is some doctors refuse to accept PFFS or other Advantage plans. While your primary doctor may agree to accept Advantage, the surgeon you need and want in the future may not agree to accept your Advantage policy. Plus your Advantage Annual out-of-pocket maximum could easily exceed that of a Medicare Supplement (Medi-gap) policy. I know of elderly folks who have attended these meetings & signed up for these free policies to gain all the freebies only to later discover their Advantage coverage failed to meet their needs.