Medicare vs Medicare Advantage Plans
Every year between Oct 15 - December 7, is the Medicare Open Enrollment period. It is during this time frame that you can re-visit your Medicare plans, including supplements, drug plans and Medicare Advantage plans.
There are specially trained volunteers through your state’s Senior Health Insurance Program (SHIP) who can help you explore various options that can better meet your wellness and financial needs. You can Google their phone number for the SHIP program in your state. It’s a free service.
Medicare picks up 80% of your hospital and provider costs. Most providers accept Medicare and you don’t need referrals to see specialists. They pay for durable medical equipment, rehab, and therapy.
Every Medicare supplement plan offers the same basic benefits and picks up the 20% of expenses that straight Medicare A & B don’t cover. It’s okay to select one with a cheaper monthly premium! The services offered are generally all the same regardless of the cost.
My husband and I have straight Medicare A & B with a supplement that is very reasonably priced. We’ve both had several surgeries, diagnostic tests and visited multiple specialists and have had ZERO out of pocket expenses. We can travel anywhere in North America and be covered for any necessary and eligible health care.
I tell my clients to run away from Medicare Advantage plans. While they offer cheaper or zero monthly premium plans and entice you with perks, such as vision and dental, they are not always there when you need them.
One of the biggest issues with Medicare advantage plans is that they can drag their feet on pre-authorizing surgery or diagnostic treatments, which can often be life threatening. They also can have very limited networks of providers/hospitals/rehab centers/skilled nursing so you could get stuck with a provider or agency you don’t like or which provides inferior care. They also might not cover you outside of your geographical area which is detrimental if you like to travel. They also are owned by private enterprises- not the federal government- so they can go out of business if they’re not profitable.
They don’t always cover you for durable medical equipment that you might need one day. Once you’re on a Medicare advantage plan, and you decide to go back to straight Medicare and a supplement plan, the supplement can charge you more money if you have medical issues such as a pre-existing condition.
