What Is Medicare Advantage?
Medicare is a federal health-care program that provides coverage for senior citizens, as well as people with disabilities or certain medical conditions. In most cases, people can begin to enroll in Medicare when they turn sixty-four years and nine months old.
According to the Centers for Medicare and Medicaid Services, Medicare Advantage is a type of coverage that combines benefits from Medicare Part A and Medicare Part B. While the federal government administers Part A and Part B, private insurance companies offer Medicare Advantage plans.
Before enrolling in Medicare Advantage, however, you must complete Medicare Part A and Part B enrollment. The experts at Sunnyside Medicare can help you understand your enrollment requirements and complete the process on your behalf.
What Does a Medicare Advantage Plan Cover?
If you join this plan, your private insurance carrier will provide most of the coverage that you need. Medicare Advantage plans offer benefits that are equal to or better than Original Medicare, a.k.a. Medicare Part A and Part B.
- Medicare Part A: Part A provides coverage for hospital stays and most inpatient services, such as hospice care and rehabilitation services.
- Medicare Part B: Part B covers treatment at a clinic or outpatient services at a hospital, such as clinical laboratory services and physical therapy.
Medicare Advantage plans include all of the benefits that Part A and Part B provide. Depending on your provider, you could also enjoy additional benefits like dental care, prescription medications, and even transportation to and from medical appointments. Keep in mind that these benefits will vary depending on your plan and provider. It is important to carefully assess your options and find the best plan for your lifestyle. If you have specialized medical needs, such as a chronic illness, you can even work with the insurer to create a tailored benefits package.
Why Do I Need Medicare Advantage?
Medicare Advantage can provide significant benefits for residents of Michigan. Medicare Parts A and B have limits on the amount of coverage that they provide, which could lead to hardships later on in life. By choosing a this plan, you could close critical gaps in coverage and save thousands of dollars.
For example, Part A Medicare pays for the first sixty days of a hospital stay. If you need care from days sixty-one to ninety, you will pay $389 for every day that you stay in the hospital. For hospital stays that exceed ninety days, the government will charge you $778 per day.
Plus, you can get additional benefits that Parts A and B do not provide. When you’re struggling with a toothache or need help getting to your doctor’s appointment, these extra benefits can come in handy.
What Is the Cost of Medicare Advantage Plans?
Costs vary by plan, location, and plan provider. Typically, you will pay a lower monthly premium on Medicare Advantage than a Medicare Supplement Plan. In fact, there are many plans with $0 premiums! However, Medicare Advantage plans typically have higher out-of-pocket costs. According to the Centers for Medicare and Medicaid Services, the following factors could influence your Medicare Advantage expenses.
- The co-pays that your insurance carrier charges for each visit or service
- The type of medical services that you require
- The frequency that you need medical care
- Whether your plan charges a monthly premium
- Whether your plan covers all or part of your Medicare Part B premium
- Your plan’s yearly limit on out-of-pocket expenses for medical care
Typically to enroll in a plan, you will continue to be enrolled in Parts A and B to the federal Medicare program while paying for Medicare Advantage. You may need to pay extra co-pays or co-insurance for out-of-network care. If you have a health maintenance organization (HMO) plan, the network will not cover the cost of care outside of your network except for emergency care, urgent care, and dialysis for renal disease. The experts at Sunnyside Medicare can evaluate your Medicare options and help you find the most affordable plan.
Pros and Cons of Using Medicare Advantage Plans
Medicare plans are unique, and there are many pros and cons that you will need to consider. It’s important to consult with a licensed broker about whether Medicare Advantage is right for you.
Pros of Medicare Advantage
By choosing a Medicare Advantage plan, you could close critical gaps in your coverage. These plans offer unique benefits that you can’t get from Parts A or B, such as the following.
- Prescription drug coverage
- Dental, vision, and hearing plans
- Wellness benefits, like gym memberships
- Allowances for over-the-counter expenses, up to $325 per quarter
- Transportation for medical appointments
- Virtual visits with health-care providers
These benefits could amount to tens of thousands in potential savings.
Plus, Medicare Advantage plans always have guaranteed issue. You can enroll regardless of your health status, age, or any other factors that indicate how often you will need medical services.
Cons of Medicare Advantage
On these types of plans, your provider will limit your care to a certain network. These policies are typically HMO or preferred provider organization (PPO) plans.
You will usually need to visit medical providers within your carrier’s approved network. If you require specialty care or want to visit an out-of-network doctor, you may need a referral.
When you choose a Medicare Advantage plan, you will also need to pay co-pays for certain services. You will essentially pay a $0 or low monthly premium and co-pays for services as you need them. On Original Medicare, you have higher monthly premiums with fewer out-of-pocket costs.
Be Ready to Apply for Medicare in Michigan
Remember, the initial enrollment period for Medicare opens three months before your sixty-fifth birthday. Medicare enrollment remains open during your birthday month and closes three months later.
If you need help navigating the Michigan Medicare landscape, you need an expert on your side. At Sunnyside Medicare, our licensed agents are experts in the field and can assess your unique needs, including your eligibility for Medicare Advantage. Interested in even more coverage? Check out Dental and Vision.
Call us today for personalized care and a dedicated agent. If you’re enrolling in Medicare, don’t go it alone—trust our experts and experience the Sunnyside difference for yourself.
Looking for a Helping Hand?
Call us at 1-248-277-5948 to talk with a Sunnyside Agent. Our licensed Medicare Agents are friendly, knowledgeable and always willing to take the time to find the right plan for you! Not ready to talk on the phone? Send us an online message and an Agent will get back to you shortly. We look forward to helping you.