Why is regular Medicare better than an advantage plan?
Answered by 21 licensed agents
Making the choice between regular Medicare with Medigap/Medicare Supplement or a Medicare Advantage Plan depends on individual healthcare needs, preferences, and financial situations. Regular Medicare with Medigap/Medicare Supplement provides notable advantages in terms of flexibility, coverage, predictability, and support. Choosing to prioritize these factors you may find regular Medicare with Medigap/Medicare Supplement to be a superior option. Understanding the differences and benefits of each choice is essential for making an informed decision about healthcare coverage.
There's a lot of confusion with Medicare-Medicare Supplement/Medigap/-Medicare Advantage "alphabet soup"! Do your homework and learn the Pros and Cons of each Option! Work with someone -like ME-who can offer both: Medicare Supplement/Medigap and Medicare Advantage plans! This was you get the FACTS not the HYPE and then make the best decision for YOU! :) WE can HELP!
I cant say that it is. If you have Original Medicare then you pay 20% of your bills and no drug coverage. If you get a supplement or Medigap to cover the 20% and a drug card then it will Cover your 20%. However the premiums are higher and they do go up every year. It is only medical coverage. ( no dental or vision) It allows you go to anyone who accepts Medicare.
Medicare Advantage has to cover the exact same things as original Medicare. So they myth that they cover less is not accurate. It is a law they have to cover the same things but they also cover more. An example is many have Dental , Eye , hearing and over the counter coverage that original Medicare does not. They come in forms of PPO's so you can use them anywhere that accepts Medicare and you can use them out of state and country. The network is typically large. The Doctors now have to bill the carrier you picked and not Medicare. It does NOT replace Medicare. Nothing can replace your Medicare.
Some States vary on this. Some states and counties just don't have access to Medicare advantage. In that instance, you will need a medigap.
The Medicare Advantage is also Guarantee Issue : Which means everyone is accepted regardless of medical back ground. Supplemental or Original Medicare you have to be medically approved or healthy to be accepted unless you are in your original enrollment period.
Regular Medicare is not better than an Advantage plan. The main reason Original Medicare (OM) is considered better than an Advantage plan is that it is accepted by most hospitals and doctors whereas an Advantage plan is limited to a network of care.
Generally speaking, there are more benefits to having a Medicare Advantage Plan than to stay in Original Medicare. Dental, vision, and hearing benefits are not covered by Original Medicare and Medicare Advantage Plans often offer different levels of these benefits. With Original Medicare you'll have out of pocket expenses unless you purchase a separate plan like a Medicare Supplement, and a separate Prescription Drug Plan. A Medicare Advantage Plan typically includes your Prescription drug plan. The one benefit to having Original Medicare versus an Advantage Plan is the doctor and hospital network. With Original Medicare, you can see any doctor and be treated at any hospital that accepts Medicare. With an Advantage Plan, you would need to make sure your doctors and your preferred hospital are in the network.
I’m not sure that this is the case, and he has everything to do with number one, your income, number two, your ZIP Code, and number three, how much are you paying with your regular insurance? It’s important to work with an agent that evaluates all of that and ask those questions for instance, this morning, I had a phone call from the lady that said her husband are going to be retiring soon and he has a company that’s going to pay their insurance for the rest of their life And I said well let’s find out how much you’re paying. I asked how much they were paying, and after we did the evaluation, we found out that it would be more expensive for them to go on a Medicare advantage plan or a Medicare supplement plan, so I suggested to them to stay where they’re at.
This also has a lot to do with whether you need freedom to go wherever you need to go Nationwide wherever original Medicare is accepted or your insurance is or gives you the freedom to go wherever you need to go and your Health Issues there’s a lot of concerns here with this question, so make sure you work with the agent that does a deep dive Discovery on your background, your history, etc.
Original Medicare is not better than an Advantage Plan. Original Medicare does not include a drug plan, it doesn’t offer dental or vision coverage. Medicare Advantage Plans vary, but there are several that include your drug plan, and offer some vision and dental allowance, and most have the time have no additional premium. But you should let a licensed, certified agent assist you to ensure that you select a plan that is best suited for you and your needs to ensure that you have selected a Medicare Advantage Plan that has everything that you want and need. There are numerous plans on the market and each is designed and tailored for people with various needs, for instance Military Veterans have a specific type of plan designed for their needs. If you are not a Veteran, that would most likely not be a good fit for you.
Regular Medicare has a larger physician network than advantage plans. For regular Medicare, the network includes any doctors that accept Medicare patients. Advantage plans limit coverage to those doctors that participate in plan's network. Regular Medicare partnered with a Medicare supplement may pay for most or all deductibles depending on age when enrolled in the supplement. The trade-off is the there is a monthly premium for the supplement while many advantage plans can be enrolled with little or no monthly premium. A licensed insurance agent can identify what plan options are best for your individual financial situation.
There is actually no such thing as "Regular Medicare". People know that there are two options when one turns age 65: A) a Medigap, also known as a Medicare Supplement and, B) a MAPD, a.k.a., as a Medicare Advantage Plan (with drug coverage). There is no cookie-cutter answer to choosing one over another since one's finances come into play, along with any potential health history of the applicant and her/his family history for "co-morbidities". If your parents lived a long life, that usually means you're ahead of the game, if you will. The major difference with an Advantage plan is though there is no monthly premium for this plan (since it is govt-subsidized), the give & take is that each MAPD has a steep deductible which you are responsible for which renews every single year. The dollar costs for these plans are dependent upon our global inflation. The Medigap, with a monthly premium has no deductible except for the one-time/year Part B $257.00 deductible. Each and every deductible will be likely to change at the new calendar year. Remember: an MAPD Advantage plan usually includes your drug coverage, whereas a Medicare Supplement plan has nothing whatsoever to do your prescriptions. That's what a "Stand-Alone" Part D plan is used for.
Do you like having the choice and control of your health care? Do you prefer that you can see any doctor, in any city, in any specialty and capacity, as YOUR CHOICE? Do you want coverage when you travel? Do you want to know that once you choose Original Medicare and a Supplement, you will never be fully responsible for a total bill? The MA plan today, may not be there tomorrow, and the doctor who accepts it today, may not accept it tomorrow!
Yes, MA makes it sound nice with glasses, teeth cleaning, maybe even a grocery card, but you then give them control of your health completely. So please consider that in your thinking.
Maybe you mean, why is a Medicare Supplement better than a Medicare Advantage plan? There are pros and cons depending on your needs. I would recommend you speak with your local licensed agent to find out what your needs are and to give you a thorough overview of the differences.
Many people like the simplicity of Medicare and a Supplement. There are very few rules to go by. With the Medicare advantage plan there are networks and other rules that have to be followed.
Your original Medicare Parts A & B does NOT include ancillary benefits, some examples would be dental, vision, free gym membership, hearing aids plus much more. There are plans available at no cost.
Regular Medicare offers more freedom and flexibility in choosing providers and is generally considered more comprehensive, but can be more expensive.
Medicare Advantage plans can be more affordable and offer extra benefits, but may have restrictions on provider choice and require prior authorization.
The plan you choose will depend on your individual needs, preferences, and priorities. It is important to carefully weigh the pros and cons of each plan and consider factors like provider network, cost, and additional benefits. Consulting with a qualified Medicare expert can provide personalized advice and help with making an informed decision.
Who might consider Original Medicare:
1. Individuals who value flexibility and choice: With Original Medicare, you can choose any doctor, specialist, or hospital in the U.S. that accepts Medicare. This can be attractive for those who have preferred providers or want to avoid network restrictions.
2. Those who prefer a fee-for-service model: Original Medicare operates on a fee-for-service basis, where you pay a portion of the cost of covered services, and Medicare pays the rest. This can be a simple and straightforward approach for some individuals.
3. People who may have a Medigap policy: Many people with Original Medicare also have a Medigap policy (supplemental insurance) to help cover some of the out-of-pocket costs, like deductibles and coinsurance. This can make Original Medicare more financially manageable.
4. Those who may not need extensive additional coverage: Original Medicare provides a good foundation of healthcare coverage, and some individuals may not need or desire the added features and benefits offered by Medicare Advantage plans, such as additional coverage for vision, dental, or hearing.
5. Individuals who want to avoid network restrictions
Who might consider Medicare Advantage:
Individuals who prefer all-in-one coverage with low premiums and copays limited by an out-of-pocket maximum .
Those who live in areas with broad networks and don't mind getting referrals .
Individuals who can't afford a Medicare Supplement (Medigap) plan or who have a lower premium requirement .
Those who prioritize extra benefits like dental, vision, and hearing coverage .
Original Medicare (Parts A and B) offers unmatched flexibility, letting you visit any doctor or hospital nationwide as long as they accept Medicare which is great for rural areas. Unlike MA plans, it doesn’t require prior authorizations or restrict you to networks, ensuring faster access to care.
However, MA plans cap out-of-pocket costs and bundle extras like dental. Original Medicare only covers 80% of health care costs and there is no cap on out of pocket expenses.
One of the benefits of regular Medicare is that you don't have any restrictions on the network that you can go to for healthcare. Original Medicare has the most flexibility in where can get healthcare in the US, but it has drawbacks as well. Original Medicare typically covers 80% of the medical bills and has certain deductibles and copays to fulfill. Advantage plans are usually designed to keep out-of-pocket costs lower while providing a coordinated network for healthcare. One way that can be competed with while being on original Medicare, is to buy a "Supplement" that compliments Medicare and picks up the 20% cost share and various other charges. This decision hinges more on your health, personal finances and lifestyle than anything as one choice may be better for you but neither are better than the other for every single person.
Regular Medicare is not necessarily "better" than an Advantage Plan. There are too many variables and the insurance coverage that makes the most sense is situational to each person. If an agent offers the blanket statement that either direction is overall "better" for everyone, run the other way.
Well, that all depends on an individual and their needs. Both types have pros and cons to them. That is why as a broker we do individual assessments and decide what would be best for that person. If that is something you would be interested in I would be more than happy to discuss it further with you.
