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Medicare Misconception: “Medicare Advantage plans are complicated”

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Medicare can be complex to understand. When it comes to Medicare Advantage (MA) plans, some may think, “Medicare Advantage plans are complicated.” Our licensed advisors are well-versed in this subject and are here to walk you through MA plans in a simple way.

All-in-One Plan, Low-Cost Approach Explained

If you are looking for an all-inclusive plan, MA may be a good option for you. MA plans (also called Medicare Part C) are offered by private insurance companies and include the same coverage offered by Original Medicare – Medicare Part A and Part B coverage. MA plans also have additional benefits that Original Medicare does not cover. For example, Medicare Advantage with Prescription Drug Coverage (MAPD) combines medical and drug coverage. Many MA plans have a low or $0 monthly premium. This makes it easier to keep track of your health expenses.

An MA plan comes with an out-of-pocket maximum that is designed to protect you from high medical expenses since it caps the total annual amount you’ll be responsible to pay out of pocket for health care costs. Once you reach your out-of-pocket maximum, your MA plan will cover all other qualified medical expenses for the remainder of the year. It’s important to note that an out-of-pocket maximum is not the same as a deductible.

Copays Explained

A copay, which is a fixed dollar amount that you pay each time you visit the doctor, is part of the MA plan structure. Medicare Supplement plans don’t have copays, but they have a monthly premium that increases annually. Many MA plans have a low or $0 premium and allow you to pay copays as you use your plan throughout the year versus paying a premium regardless of plan usage. As mentioned, with an MA plan, you also have an out-of-pocket maximum which provides a safety net for your health care spending.

Benefits Explained

MA plans include a variety of great built-in benefits and most plans include drug coverage (Medicare Part D). Benefits may include:

  • Dental coverage
  • Hearing coverage
  • Vision coverage
  • Telehealth benefits
  • Over-the-counter allowances
  • Fitness memberships

Networks Explained

Each MA plan has a list of specific doctors, hospitals, and facilities that are considered “in-network.” Most MA plan networks are quite large and often include multiple hospital and provider systems across your state. There are even some MA plans that have a national network, which is a great option if you consider yourself a snowbird. 

How We Can Help

Our client advisors are here to answer your questions about MA plans. If you want to learn more, reach out to us at 877.222.1942 or schedule a call

If you are not a RetireMed client and you’d like to learn more about Medicare or individual health insurance, contact us at 937.915.3563 or schedule a call.


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