Do Medicare Advantage plans really save seniors money in the long run? Why or why not?
Answered by 32 licensed agents
Medicare Advantage plans can potentially save seniors money in the long run, but the impact varies by individual circumstances. They often have lower premiums and may include additional benefits not covered by Original Medicare, such as vision and dental care. However, these plans might have higher out-of-pocket costs for certain services and often require members to use a specific network of providers. It’s important for you to evaluate their healthcare needs and compare costs before choosing a plan.
Medicare Supplements premiums go up every year and so do the drug cards. You pay that larger premium each year weather your sick or not.
On Medicare advantages, most of them premiums are No cost and you pay Copay as you use them. The Copays control the costs and the copays cap out each year. Less than 1% ever hit the max copay or max out of pocket on a Medicare advantage plan.
You may have a few bad years but not every year and over time Medicare advantages do save you money. Not just on premiums but they also have extra dental, Vision, hearing and over the counter items that Original Medicare does not.
They can save you money short term — and long term if you stay healthy. But it’s a gamble. If you get sick, out-of-pocket costs and network limits can add up fast.
Yes I believe Medicare Advantage plans can save a Medicare beneficiary a lot of money, especially if a catastrophic event occurs. Medicare Advantage plans are required to have a maximum out of pocket each year. Original Medicare has no maximun out of pocket. Medicare Advantage plans can also provide a credible drug plan at no additional cost. Many Advantage plans offer extra benefits and savings on things original Medicare does not cover, like a little dental, vision and free gym membership in some cases. There are many very good reasons to enroll in Medicare Advantage also known as part C. Medicare Advantage plans very from zip code to zip code, county to county and state to state. I think it is important to talk with a very experience Medicare plan expert that is independent. Got questions call or email today for a free analysis and quote.
Medicare Advantage plans may be less expensive when you are healthy. Medicare supplements or Medigap may be less expensive if the worst of the worst happens to you. However I can give you examples directly from my clients who have ended up paying more on a Medicare Advantage plan. While you may feel healthy now 85% of our Medical Care comes after age 65.
Medicare Advantage can be a cost savings for many seniors. With drug, vision, and dental care included, many people who are budget conscious can take advantage of this.
Yes, they do. I have a study comparing Medigap and Medicare Advantage over 20 years, and even if beneficiaries reach their max out-of-pocket half the time, Medicare Advantage still comes out ahead in overall costs.
They can. Medicare Advantage typically offers additional benefits such as Dental, Vision and Hearing- the emphasis on these plans is Preventative Care. The better you take care of your health, the less costly it tends to be.
If you break it down, usually a Medicare Advantage plan is about $0 monthly premium, and includes your prescription drug coverage. You will still have to pay your Part B premium (in 2025 the standard premium is $185) and any copayments associated with your plan for doctors visit, procedures, medications. This is why Medicare is considered the Pay as You Go Plan. And that suits some people just fine.
With a Medicare supplement, you are responsible for your Part B premium, your Medicare supplement premium, your prescription drug plan premium and any additional policies you may require such as a Stand-alone Dental, or bundled Dental, Vision and Hearing policy (because Medicare Supplement plans do not include coverage for these). This is why a Medicare Supplement/Medigap plan is known as a Prepaid Plan.
Depending on your health issues if any, it may have been a great decision or if you suffered thru many health downturns with a lot of hospitalizations, a Medigap might have been the better choice in the long run.
Not consistently. It could cost more, especially for people who have just turned 65 or someone who has many medical issues.
While Medicare Advantage plans offer little to no premiums, deductibles, max out-of-pocket, copays, and coinsurance can add up over time. For someone who doesn't have a lot of medical issues, doesn't go to the doctor often, or utilizes the VA, it could save them money.
Many times, the premiums on a Medicare Supplement and a standalone drug plan (Part D) are less than the max out-of-pocket on a Medicare Advantage plan.
It is best to review your options with a broker or agent who can explain all details to you.
Yes and no. It really depends on the client. I do have clients that have been on a low-cost advantage plan for years and truly have not seen any specialist and take very little generic medication’s. Those folks have saved thousands of dollars over the years. I also have clients that were attracted to a low monthly premium, but have paid a lot in out-of-pocket cost for providers, hospital, states, specialist visits, MRI, etc.. The biggest disadvantage that I have come across on advantage plans is the limited network. I always encourage clients to pay close attention to an advantage plans “MOOP”. I will often compare that cost to a yearly predicted cost on a Medicare supplement plan to help paint a picture of the difference between advantage and supplement.
Medicare Advantage plans don't necessarily save money in the long run for all seniors. While some plans offer lower premiums and out-of-pocket limits, network restrictions and pre-authorization requirements can lead to unexpected costs. If you are healthy and want predictability, Medicare Advantage might be a good option, but if you prefer flexibility or have complex health needs, traditional Medicare with a Medigap (supplement) plan could be more cost-effective.
Every person is unique so the answer is that plans can save money under many circumstances...and occasionally when a Plan doesn't work for that client, then an Independent Broker can explain better options for the client.
In my opinion it depends on each individual client and their financial situation and generally speaking the older the client gets is when it can save more due to Medicare Supplement prices can increase annually and after several years can become very pricey where as Advantage plans many time have zero or very low premiums plus offer additional added benefits not offered by Supplements.
They could save people money in the long run. Most advantage plans have a $0/month premium. Most plans have very reasonable, low copays if you see a doctor. If people aren't using their insurance very much, they would be paying very little copays and would be paying no premium year after year. If someone has Original Medicare and buys a supplement, those supplement plans could get expensive. Premiums will go up each year too. People that have supplements pay higher premiums, that go up every year, regardless if they ever use their insurance.
You can save money with Medicare Advantage in most situations. However if you are in need of Part B drug treatment long term, Medicare Advantage can be more expensive than straight Medicare and a supplement. Also if you take expensive prescriptions you need to be careful, as well.
This is a trick question. As brokers, we can not predict the future. If you have a healthy year and used your extra benefits built into your advantage plan, then yes, you could save money. However, if you have a bad year of health issues, then you could possibly be paying more out of pocket. At the end of the day, you do have a Maximum-Out-Of-Pocket that will put a cap on your out of pocket cost for the calendar year.
Medicare Advantage plans don't consistently save seniors money in the long run & may even lead to higher overall costs. While they may offer lower premiums & out-of-pocket limits, the added costs & restrictions can negate those savings. Here's a more detailed explanation: Potential Savings: Lower Premiums: Some Medicare Advantage plans offer zero or very low monthly premiums, potentially saving seniors money compared to traditional Medicare Part B. Out-of-Pocket Limits: Many Advantage plans have out-of-pocket maximums, meaning you won't be charged more than a certain amount for medical expenses in a year. Potential Drawbacks: Higher Total Costs: Studies have shown that Medicare Advantage plans can be more expensive overall for beneficiaries than traditional Medicare. Provider Network Restrictions: Advantage plans often have limited provider networks, which can mean higher costs or delays in care if you choose to see a doctor outside of the network. Pre-authorization Requirements: Some Advantage plans require prior authorization for certain procedures or treatments, which can be a hassle & may delay care. Hidden Costs: Additional benefits like dental or vision coverage may have limits or be subject to extra fees. Cost-Sharing: Even with lower premiums, Advantage plans may have higher co-pays or deductibles compared to traditional Medicare.
When Advantage Plans Might Save Money: Healthy individuals: If you are generally healthy & don't need a lot of medical care, Advantage plans might offer a predictable way to manage healthcare costs. Those who prioritize lower premiums & out-of-pocket limits: If you are willing to accept network restrictions & other potential drawbacks, Advantage plans can be a good option for managing your healthcare spending. When Traditional Medicare + Medigap Might be Better: Those with chronic health conditions: If you have complex health needs or regularly require specialized care, traditional Medicare with a Medigap plan might work
Depending on your health condition. it's a complex decision that depends on individual circumstances. may have lower premiums or offer extra benefits, they often come with trade-offs like network restrictions and potential higher costs for out-of-network care.
Medicare advantage plans are designed for people with average to below average retirement income. They have a lot more deductible and copayments than regular supplement plans.
Medicare Advantage plans have an incentive to focus on preventive care, especially for chronic conditions, which can prevent big events from happening - such as hospitalization which costs more. Preventing hospitalization saves more than just money, as it adds to the quality of life for clients.
It depends on your needs. If you frequently see specialists and needs to do exams many times a year, then MedSup may be your best choice. Your monthly cost will be the Part B, the Drug plan and the Med Sup premium.
If you enjoy fairly good health, you can choose a Medicare Advantage plan that covers parts A, B and D (drugs) that costs $0 monthly premium. Your only cost will be whatever SSA charges for your Original Medicare part B costs (generally $185.00/mo)
Insurance whether a Medicare Advantage Plan or Medigap Plan is a transfer of Risk. Medicare Advantage Plans, in my experience, do save seniors money if designed properly.
The answer is "yes but It depends". Compared to Original Medicare alone the savings are HUGE! In average advantage members save due to most plans having zero or low premiums and zero or low deductibles with a max annual out of pocket amount something Original medicare doesn't have.
Some people compare Medicare Advantage to Medicare Supplements but the comparison is not apples to apples. The big disadvantage Medicare Advantage when compared to med supps is not financial, is the accessibility to providers due to network restrictions. Med supps are standardized mostly while Medicare Advantage plans are designed in many shapes and forms to accommodate different populations, incomes and in some cases even specific medical conditions.
The answer is Yes they could save people a lot of money. Speak to a licensed and objective agent before making a decision on a plan.
It is really impossible to tell. Every situation is unique. Let's say you compare an Advantage plan with a Supplement plan. Advantage plan could cost as low as $0 monthly (still have to pay Part B), includes a prescription plan as well as some dental, vision and hearing benefits plus some other extras such as over-the-counter debit card. Supplemental plans do not offer any of those and might cost let's say some $200 per month. You still have to pay your Medicare Part B premium, get a separate drug plan as well as dental/vision/hearing coverage but you get more freedom when choosing your providers ,little if any co-pays, no referrals,...For some additional clarity, of all Medicare beneficiaries about 50% have an Advantage plan and about 20% have a supplement plan.
That depends on a bunch of different factors. Determining needs on a case by case basis is the best way to analyze if a Medicare Advantage plan will save money in the long run.
This is a complex question that will need to be viewed from the lens of the unique needs each individual has. There are pros and cons to Medicare Advantage plans. They work great for some and there are better options for others. In order to answer this question fully, it would take a review of your personal situation.
Enrolling in Medicare Advantage or Plan C, actually disenrolls you from Original Medicare and Medicare is no longer your insurance provider. Instead, Medicare pays a private insurance company, the Advantage plan you choose, a fixed dollar amount based on your geographic location, whether you see them for services or not! In exchange, the Advantage plan assumes 100% responsibility for all costs for care. As a result, all Advantage plans impose cost sharing requirements through coinsurance and co-pays with annual out of pocket expenses for members ranging from $2,550 to $11,900 per year. Be sure to look at this closely if you are considering an Advantage plan so you are not surprised by a high bill after treatment.
The benefit of Medicare Advantage is typically lower up-front cost like little to no premium and they often include limited benefits on dental, vision, and even gym memberships to encourage enrollment, but when major medical care is needed, clients may experience delayed and limited care options as well as higher overall out of pocket costs for care.
Original Medicare on the contrary allows you to go to any doctor, hospital, or provider that accepts Medicare. Medicare is primary insurance and pays providers for services when rendered with no preauthorization requirements for standard Medicare services. We recommend a good Medicare Supplement policy (Medigap) to the cover the cost for services Medicare approves but does not pay which reduces your annual out-of-pocket cost for approved services to as low as $257 per year in 2025 on a plan G.
Because Original Medicare with Medigap provides clients a better overall healthcare experience due to the increased service options available to clients along with a lower overall out of pocket costs for care when needed. For this reason we believe the better overall care experience far outweights the modest needed to cover the upfront costs for supplemental insurance premiums.
Absolutely! With Original Medicare, there is no STOP to your risk of cost. With Part A the Hospital Deductible is $1,676 for days 1-60, then a per-day copay of $419 for days 61-90 and $838 per-day copay for days 91-150. After that Original Medicare doesn't cover any cost. Outpatient cost or Part B has an annual Deductible of $257 and a 20% unlimited copay. All Medicare Advantage Plans have what is called a Maximum Out Of Pocket limit. This limits your risk.
