Do Medicare Advantage plans save money?

Question

Pete Alberti · Accepted Answer

The question of whether Medicare Advantage plans save money is complex, with varying perspectives. Here's a breakdown of key considerations:
Potential Cost Savings for Individuals:
 * Lower or Zero Premiums:
   * Many Medicare Advantage plans offer low or even $0 monthly premiums.
 * Out-of-Pocket Maximums:
   * These plans typically have a limit on your annual out-of-pocket expenses, providing a degree of financial protection. Traditional Medicare lacks this cap.
 * Additional Benefits:
   * Many Medicare Advantage plans include benefits not covered by Original Medicare, such as dental, vision, and hearing care, which can lead to cost savings if you utilize these services.
 * Consolidated Coverage:
   * Medicare Advantage plans often combine Medicare Part A, Part B, and Part D (prescription drug coverage) into a single plan, streamlining costs.
Concerns About Overall Costs:
 * Higher Costs to the Medicare System:
   * Reports, such as those from the Medicare Payment Advisory Commission (MedPAC), indicate that Medicare Advantage plans can cost the Medicare system more than Original Medicare. This is due to factors like how the plans are paid, and coding intensity.
 * Potential for Hidden Costs:
   * While premiums may be low, Medicare Advantage plans can involve copayments, coinsurance, and other out-of-pocket costs that can accumulate.
 * Prior Authorizations and Network Restrictions:
   * Medicare Advantage plans often require prior authorizations for services and have network restrictions, which can limit access to certain providers and potentially lead to unexpected costs.
In summary:
 * For some individuals, Medicare Advantage plans can offer potential cost savings through lower premiums and added benefits.
 * However, from the perspective of the overall Medicare program, there are concerns that these plans may increase costs.
 * It is very important for an individual to carefully review the details of any medicare advantage plan they are considering.

Joseph Bachmeier · Answer

If you have a Medicare Advantage plan and never use it too much it could save you a lot of money. Most Advantage plans I sell are $0 premium a month. However, if you have a lot of chronic conditions and see medical providers often it could cost you a lot of out of pocket expenses. The good thing though there are out-of-pocket maximums on Advantage plans

Answered by Joseph Bachmeier on March 28, 2025

Agent Licensed in PA, DE, FL & MD, NC, NJ & SC

Answered by Joseph Bachmeier Medicare Insurance Agent

Charles Fletcher · Answer

Medicare Advantage plans may not save you money if you have what I call a "bad health year". The maximum out of pocket risk is part of what gives you the lower premium comparatively. Also factor in the risk for the 20% gap for Part B drugs (drugs administered at the Dr's office) and Durable Medical Equipment. If you are reasonably health, MA plans may save you money in the long term. Imagine a scenario where one insured person choose the Supplement and Drug Plan option and pays $300 a month, every month, for 10 years. That would be $36000 spent overall and very little extra risk. Those same 10 years on a Medicare Advantage plan may cost $0 on the premium and some copays. But you'd have to have around 5 "bad health" years in order to spend $36000 when the Max out of pocket for your plan is $6000 a year. So, if your health is reasonably good, MA plans may save you some serious money in the big picture.; When you factor in MA plans supplemental benefits like dental, vision, hearing, gym membership and OTC spending they are a very good consideration for your health insurance.

Answered by Charles Fletcher on April 4, 2025

Agent Licensed in WA, AZ, ID, NV & TN

Answered by Charles Fletcher Medicare Insurance Agent

Timothy Brown · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/do-medicare-advantage-plans-save-money#timothy-brown-17110

Mal Varlack · Answer

Yes. Versus you having no plan at all or Original Medicare. Absolutely. Medicare Advantage Plans have a “cap” on the amount you spend out of pocket yearly. With Original Medicare (just the red, white and blue card) you don’t have a cap and are subjecting yourself to 20% of the cost of healthcare and THERE IS NO LIMIT. Also instead of paying the full bill for a visit or a medication (if covered), you pay a copay (a set amount) or a coinsurance ( a specified percentage).

Answered by Mal Varlack on April 17, 2025

Agent Licensed in FL

Answered by Mal Varlack Medicare Insurance Agent

Steve Brauer · Answer

Yes, Medicare Advantage saves you money, but you will still pay copays when you use services. The copays and out of pocket costs vary greatly depending on the plan. With a MediGap plan, you pay quite a bit up front for services you MAY use. The Medicare Advantage model is more of a "pay as you go"

Answered by Steve Brauer on April 16, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

Tony Hardwick · Answer

Medicare Advantage plans can help save money by providing a $0 monthly premium and providing assistance with prescription costs. If you have no specialty doctors you'll have a $0 co-pay to see your primary doctor. You can even qualify for extra help with prescriptions and drug deductibles.

Answered by Tony Hardwick on March 31, 2025

Agent Licensed in GA, AZ, CA & 15 other states

Answered by Tony Hardwick Medicare Insurance Agent

Michael Claunch · Answer

You definitely save money on your premiums and Medicare B deductible. How much you save all comes down to how high is your supplement premium vs how much you use your Medicare Advantage and what is that plans max out of pocket.

Answered by Michael Claunch on April 7, 2025

Agent Licensed in TN

Answered by Michael Claunch Medicare Insurance Agent

Do Medicare Advantage plans save money?

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