Medicare Advantage Plan

Medicare Advantage Plans have gotten a negative rap over the past few years. One prominent website that sells Medigap plans practically rails against Advantage plans (like HMO's and also PPO's). The owner of the site goes so far as for you to say that Medicare beneficiaries are always better off with Initial Medicare (Part A and Part B) than with a Medicare Advantage Plan. Why are usually some individuals so vocal in their opposition for you to these plans? And listed below are certain reasons why I believe this is the situation.

1. Many unscrupulous agents have sold Medicare Advantage Plans without really considering what was in the best attention of the Medicare beneficiary. Stories have abounded about "grandma" being rolled over into some new plan that did certainly not include her doctor or medication.

I have personally been in the kitchen with Medicare Beneficiaries who were crying, mainly 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 and CMS (the Center for Medicare as well as Medicaid Services) have clamped down hard on these kinds of activities. The bad news is, there are still a host of agents (as well as 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 absolutely nothing. The truth is nonetheless, not necessarily 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.

Besides 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 for you to pay a huge sum of money for your share of your medical costs.

3. Restrictions to Networks and also Plan Rules

Another gripe often leveled against Medicare Advantage plan is that Medicare Beneficiaries are restricted in order to seeing only providers that are approved by the plan. In an HMO (Health Maintenance Organization) for example, you must normally select a Primary Care Physician (PCP) as well as if you want for you to see a specialized, you must get a reference from your PCP before you do so.

With all of those "strikes" against Medicare Advantage Plans, perhaps you are expecting me in order to say, along with that other author I mentioned, that Medicare Advantage Plans are never the right choice for people with Medicare.

That nevertheless is not likely the case. You will discover many situations we have encountered where it appears at least (in our judgment) that a Medicare Advantage Plans is in the best interest of a client and also does deliver better protection than Original Medicare (Part A & Part B) alone.

You'll find many, many, many people who absolutely, positively, under no circumstances, cannot afford in order to pay a monthly premium (for a Medicare Supplement Policy along with or a Prescription Drug Plan).

I am of the opinion that if you CAN afford in order to pay a premium for Medigap as well as a Part D Plan (as well as it does pay for you to shop around) that you should pay the premiums along with be done with it. If you cannot afford it nevertheless, there may possibly indeed be plans that provide protection over and above Original Medicare (plans for example that give you an intensive Maximum Out of Pocket, or MOOP).

Are Medicare Advantage Plans right for everybody? As expected certainly not. Just as there is not likely one retirement plan, or life health insurance plan or long term care plan that is certainly not best suited for every person, there is simply no way to say that Medicare Advantage is "best" or that a Medigap policy is "best."

It is nevertheless, too simplistic in order to say that Medicare Advantage is never in the best interest 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.