Medicare Advantage is a fast-growing form of private Medicare plan that offers all-in-one medical and drug coverage. About 31 percent of Medicare enrollees are in Advantage plans in 2016, up from 11 percent in 2010; that number is expected to hit 41 percent by 2026, according to a forecast by the Congressional Budget Office.. 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 benefits they offer. The plans also can offer-and charge for-supplemental benefits 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, which runs from 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.
For 2017, the Medicare Advantage plan market looks stable. Average monthly premiums are expected to fall 4 percent, to $31.40, according to the Centers for Medicare & Medicaid Services (CMS), the federal agency that runs the program. 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. Also re-check prescription drug coverage as you would a standalone drug plan.
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