Do Medicare Advantage plans really save seniors money in the long run? Why or why not?

Question

Sean Davis · Accepted Answer

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.

Answered by Sean Davis on March 26, 2025

Broker Licensed in NY, LA, MD & 6 other states

Answered by Sean Davis Medicare Insurance Agent

Tasha Riggs · Answer

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.

Brian Krantz · Answer

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.

Robert Pennington · Answer

Advantage Plans will save money if your on a PPO Plan and pays in and out of network.  HMO Plans pay in network, but normally you pay out of network.

Dutch VanHoesen · Answer

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.

Answered by Dutch VanHoesen on March 25, 2025

Broker Licensed in FL

Answered by Dutch VanHoesen Medicare Insurance Agent

Bryan Smith · Answer

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.

Answered by Bryan Smith on March 10, 2025

Broker Licensed in UT, AL, AR & 35 other states

Answered by Bryan Smith Medicare Insurance Agent

Samantha Jellison · Answer

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.

Michael Denniston · Answer

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.

Answered by Michael Denniston on March 25, 2025

Agent Licensed in FL, AL, AR & 11 other states

Answered by Michael Denniston Medicare Insurance Agent

Gregg Matheny · Answer

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.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

John L Herman Jr · Answer

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.

Answered by John L Herman Jr on March 31, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent

Steve Houchens · Answer

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.

Answered by Steve Houchens on April 2, 2025

Agent Licensed in KY & TN

Answered by Steve Houchens Medicare Insurance Agent

Michael Kim · Answer

Yes. Because Medicare Advantage Plans do not have monthly premiums, they cover medical, prescriptions, dental, hearing, vision, and other benefits.

David Silver · Answer

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.

Answered by David Silver on March 26, 2025

Broker Licensed in FL, NJ & NV

Answered by David Silver Medicare Insurance Agent

George Kolitsas · Answer

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.

Answered by George Kolitsas on March 25, 2025

Broker Licensed in CT

Answered by George Kolitsas Medicare Insurance Agent

Vachik Chakhbazian · Answer

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.

Answered by Vachik Chakhbazian on April 15, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Mike Henry · Answer

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.

Aisha Saleem · Answer

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.

Answered by Aisha Saleem on March 17, 2025

Agent Licensed in MD & FL

Answered by Aisha Saleem Medicare Insurance Agent

Andre Cabral · Answer

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)

Darko Bozic · Answer

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.

Answered by Darko Bozic on April 9, 2025

Broker Licensed in OH

Answered by Darko Bozic Medicare Insurance Agent

Debra Weber · Answer

I believe that it depends on the coverage and their needs.  Some plans are better than others.  It is a very personal decision.

Hector Vazquez · Answer

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.

Michael Hixson · Answer

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.

Answered by Michael Hixson on April 28, 2025

Broker Licensed in OK, AR & TX

Answered by Michael Hixson Medicare Insurance Agent

Mike Sosso · Answer

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.

Do Medicare Advantage plans really save seniors money in the long run? Why or why not?

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Do Medicare Advantage plans really save seniors money in the long run? Why or why not?

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