Medicare Advantage is growing in popularity every year, but there are still some facts about Medicare Advantage you don’t (but should) know.
1. Enrollment has nearly doubled over the past decade.
One-third of all Medicare enrollees has a Medicare Advantage plan. Between 2018 and 2019, enrollment grew 8 percent, the same rate in which it grew the previous year. The Congressional Budget Office estimates 47 percent of all Medicare enrollees will be enrolled in a Medicare Advantage plan by 2029.
2. You have the exact same coverage as Original Medicare—plus some extras.
By law, Medicare Advantage plans must provide the exact same coverage as Part A and Part B of Original Medicare, but most plans also cover extras like dental, vision, and hearing benefits. These extra benefits are often the reasons seniors choose a Medicare Advantage plan over Original Medicare.
On top of everything covered by Original Medicare, 67 percent of Medicare Advantage enrollees have dental benefits, 72 percent have fitness benefits, and 78 percent have vision benefits.
3. More than half of enrollees pay no extra premium.
Medicare Advantage enrollees are still required to pay the Part B premium, but 56 percent don’t pay an extra premium for their Medicare Advantage plan. In 2019, 18 percent paid $20-$49, 14 percent paid $40-$99, and 7 percent paid more than $100. The average premium in 2019 is $29 per month. Even better, Medicare Advantage premiums have been dropping since 2015.
4. Medicare Advantage plans have more rules.
Unlike Original Medicare, which allows you to see any doctor that accepts Medicare assignment, Medicare Advantage plans have networks you’re required to stay within if you want your plan to pay for your treatment. Many plans also require things like referrals, prior authorizations, and step therapy. Before you commit to a plan, read the fine print to see what kind of restrictions the plan has.
5. Medicare Advantage isn’t necessarily the best option for everyone.
The type of health coverage you should purchase depends entirely on your healthcare needs and lifestyle. For example, Original Medicare doesn’t cover healthcare administered outside of the United State, but some Medicare Advantage plans do. If you travel quite a bit, a Medicare Advantage plan might be right for you. However, if you have a chronic illness that requires a variety of doctors and specialists, Original Medicare has a wider range of doctors who can help you coordinate your care.
6. If you’re not happy, you can switch plans.
If your plan changes its coverage rules or you’ve found a better option, you can switch your Medicare Advantage plan. You can switch plans during fall open enrollment, which runs October 15 – December 7. To make your plan search easier, make a list of all of your medications and doctors, and educate yourself on the facts about Medicare Advantage so you can choose the right plan.
