All Medicare Advantage plans must be approved by the Medicare and Medicaid Center (CMS). They must provide services equal to or better than those provided by traditional Medicare Part A and Part B. Of course, the purpose of these plans is to provide services that offer advantages over Parts A and B!
Private insurance companies profit greatly from selling Advantage plans, and insurance agents apply these plans to seniors in the hope of earning additional profits. Of course, not all insurance brokers are corrupt; each industry has its own bad eggs. However, there are several reports where insurance agents have been found that lead their clients to buy Medicare Advantage plans in the hope of earning extra money.
While having a network of providers can be an advantage, you are usually restricted to using them unless you have an emergency. If you need a specialist other than a covered provider, you will not be covered to consult this doctor through Medicare. MA plans essentially replace your Medicare coverage.
Some Medicare Advantage plans have a bad reputation lately, but this may be due to some people’s excessive marketing efforts, not the actual plans.
Medicare Advantage Plans Have a Special “Trial” Period
The fact is, this is the period when one of the Advantage policies of Medicare can be tried after the initial enrollment period when you are eligible for Medicare coverage. This is a yearly event where you can assess the kind of Medicare Advantage policy you have registered from the myriads of alternatives put forward by various brokers and insurance companies. If you miss this opportunity, you may end up paying more and getting less coverage than you expected.
Depending on where you live, you may find many more options between MA plans than Medigap Insurance plans.
Medicare Advantage plans are undergoing many changes at the moment. Next year they will use a 5 star rating to classify their quality. Those with the highest qualifications will have an open enrollment throughout the year. So far, few plans have reached the cut, but I hope they will intensify further next year.
An example of how Medicare Advantage plans could cover an individual could look like this: a lower copayment for medical appointments that could offset reduced coverage for specialized nursing facilities. The general image that a Medicare Advantage plan produces for its target audience is that they are too good to be true because they are.