Medicare Advantage is a fast-growing form of private Medicare plan that offers all-in-one medical and drug coverage. About 33 percent of Medicare enrollees are expected to opt for an Advantage plan in 2015. Most Medicare Advantage plans are managed care programs, such as HMOs or PPOs. Some private fee-for-service and specialty plans are offered, although the ACA requires all Advantage plans to create provider networks.
When you join an Advantage plan, Medicare provides a fixed payment to the plan to cover your Medicare Part A (hospital) and Medicare Part B (medical insurance) coverage. There are usually additional copayments and deductibles, depending on the type of plan you join.
Shopping for a Medicare D prescription drug plan? Check out my shopping guide here.
Advantage plans are required to use any savings they achieve between the government payments they receive and their costs to either reduce premiums or improve the benefi ts they offer. The plans also can offer-and charge for-supplemental benefi ts such as vision, hearing, and dental care.
Shopping for Medicare Advantage plans
Medicare Advantage plans are offered at the state level, so you need to compare what’s available in your area. Enrollment for Medicare Advantage is done during the annual Medicare enrollment season; for 2015, the enrollment period will be October 15 to December 7.
You’re free to make as many changes as you want before Dec. 7; your changes take effect on Jan. 1. There’s also a dis-enrollment period that runs from Jan. 1 to Feb. 14, which can be used by seniors who pick an Advantage plan but want to change their minds. During that period, you can switch back to traditional Medicare but not to a different Advantage plan. And, if you do leave Advantage, you can add a stand-alone drug plan during that period.
Critics of the Affordable Care Act (ACA) have predicted that the new law’s provisions will send Advantage premiums through the roof and decimate plan offerings, but there’s no evidence of that yet. The Medicare Advantage plan market will be stable in 2015; Avalere Health says monthly premiums will be up 4 percent on average, with translates to just $1.30. If you like the plan you’re using, check to make sure there won’t be changes to premiums, deductibles and co-pays, or covered procedures, tests or medical facilities.
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