Do Medicare Advantage plans really save seniors money in the long run? Why or why not?
Answered by 19 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 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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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)
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.
