Medicare Advantage Plans have gotten a tough rap over the past few years. One prominent website that sells Medigap plans practically rails against Advantage plans (like HMO's as well as PPO's). The owner of the site goes so far as in order to say that Medicare beneficiaries usually better off with Unique Medicare (Part A and Part B) than with a Medicare Advantage Plan. Why are some people so vocal in their opposition in order to these plans? Listed below are some reasons why I do believe this is the matter.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 not necessarily include her doctor or medication.
The good news is, Medicare and CMS (the Center for Medicare along with Medicaid Services) have clamped down hard on these kinds of activities. The bad news is, there can be still a host of agents (along with agencies) who are still engaged with this sort of nonsense.2. Low along with Even Zero Plan Premiums Can be Misleading
Many Medicare Advantage Plans have very low or even zero plan premiums. Many folks see this along with think that they are gaining something for nothing. The truth is however, not that simple. Co-pays, Co-insurance as well as higher drug costs with many of these plans can actually cost more than premiums for a Medigap policy.
In addition to this, as we have been looking at some of the plans for 2010, you will discover some plans that have no out of pocket maximum (no stop loss, if you will). If you end up gaining really sick with some of these plans, you might be responsible to pay a significant sum of money for your share of your health costs.
3. Restrictions for you 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 choose a Primary Care Physician (PCP) as well as if you want to see a specialist, it is best to 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 the scenario. There are many situations we have encountered where it appears at least (in our judgment) that a Medicare Advantage Plans is in the best awareness of a client and does produce better protection than Original Medicare (Part A & Part B) alone.There can be many, many, many people who absolutely, positively, under no circumstances, cannot afford in order to pay a monthly premium (for a Medicare Supplement Policy and or a Prescription Drug Plan).
I am of the opinion that if you CAN afford to pay a premium for Medigap along with a Part D Plan (as well as it does pay to shop around) that you should pay the premiums as well as be done with it. If you cannot afford it even so, there may indeed be plans that serves protection over and also above Original Medicare (plans for example that produce a comprehensive Utmost Out of Pocket, or MOOP).
Are Medicare Advantage Plans adequate for everybody? Certainly not likely. Just as there is not necessarily one retirement plan, or life health care insurance plan or long term care plan that is not really ideal for every person, there is simply no way for you 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 awareness 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
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