Medicare Advantage Plans have gotten a bad rap over the past few years. One prominent website that sells Medigap plans practically rails against Advantage plans (like HMO's along with PPO's). The owner of the site goes so far as to say that Medicare receivers are always better off with Original Medicare (Part A and Part B) than with a Medicare Advantage Plan. Why are some individuals so vocal in their opposition in order to these plans? Allow me to share certain reasons why I believe this is the claim.
1. Many unscrupulous agents have sold Medicare Advantage Plans without really considering what was in the best awareness of the Medicare beneficiary. Stories have abounded about "grandma" being rolled over into some new plan that did not include her doctor or medication.
I have personally been in the kitchen with Medicare Receivers who were crying, simply because some fool agent preferred making a commission to helping that person get what the best plan for their situation.
The good news is, Medicare along with CMS (the Center for Medicare and also Medicaid Services) have clamped down hard on these kinds of activities. The bad news is, there are still a host of agents (and agencies) who are still engaged with this sort of nonsense.
2. Low as well as Even Zero Plan Premiums Can be Misleading
Many Medicare Advantage Plans have very low or even zero plan premiums. Many folks see this and think that they are obtaining something for nothing at all. The truth is on the other hand, not really that simple. Co-pays, Co-insurance and higher drug costs with many of these plans can actually cost more than premiums for a Medigap policy.
As well in order to this, as we have been looking at some of the plans for 2010, you'll find some plans that have no out of pocket maximum (no stop loss, if you will). If you end up obtaining really sick with some of these plans, you might be responsible in order to pay a major sum of money for your share of your health care costs.
3. Restrictions to Networks as well as Plan Rules
Another gripe often leveled against Medicare Advantage plan is that Medicare Beneficiaries are restricted for you to seeing only providers that are approved by the plan. In an HMO (Health Maintenance Organization) for example, you must normally decide a Primary Care Physician (PCP) along with if you want in order to see a specialized, it's essential to get a recommendation from your PCP before you do so.
With all of those "strikes" against Medicare Advantage Plans, perhaps you are expecting me for you to say, along with that other author I mentioned, that Medicare Advantage Plans are never the suitable choice for people with Medicare.
That even so is not likely the claim. You can find many situations we have encountered where it appears at least (in our judgment) that a Medicare Advantage Plans is in the best awareness of a client and also does give you better protection than Original Medicare (Part A & Part B) alone.
There are many, many, many people who absolutely, favorably, under no circumstances, cannot afford in order to pay a monthly premium (for a Medicare Supplement Policy and or a Prescription Drug Plan).
I am of the opinion that if you CAN afford for you to pay a premium for Medigap and a Part D Plan (and it does pay to shop around) that you should pay the premiums as well as be done with it. If you cannot afford it nevertheless, there may well indeed be plans offering protection over along with above Original Medicare (plans for example that give you an extensive Utmost Out of Pocket, or MOOP).
Are Medicare Advantage Plans ideal for everybody? Certainly not likely. Just as there is not likely one retirement plan, or life insurance cover plan or long term care plan that is definitely not right for every person, there is simply no way for you to say that Medicare Advantage is "best" or that a Medigap policy is "best."
It is however, too simplistic in order to say that Medicare Advantage is never in the best benefit of a Medicare Beneficiary. Medicare Advantage Plans may have gotten bad press (for a variety of valid reasons), but these plans, in my opinion are a still a good choice for many people
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