Why Would Someone Enroll in Medicare Advantage?

Hands raised, asking why anyone would enroll in Medicare Advantage.

When it’s time for you to go on Medicare, you’ve got a few choices to make. The initial – and probably the most pivotal choice – boils down to choosing between a Medicare Supplement plan and a Medicare Advantage plan. The topic of Medicare Advantage is rife with opinions and discussions. Many are quick to criticize Medicare Advantage plans.

So, what drives someone to enroll in Medicare Advantage instead of a Medicare Supplement? Like all choices, Medicare Advantage plans come with their advantages and disadvantages. And while television commercials might paint a particular narrative, it’s noteworthy that nearly 30 million Medicare beneficiaries prefer Medicare Advantage over Medicare Supplements. They must be doing something right…right?

Separating fact from fiction regarding Medicare Advantage plans can be a challenge. In this article, we’re going to explore several reasons why individuals might gravitate towards a Medicare Advantage plan.

Guaranteed Admission

While Medicare Supplements might reject applications if you attempt to switch your plan outside of your Medigap Open Enrollment Period – which is just a short 6-month period following your Part B enrollment – Medicare Advantage plans offer a more accommodating approach. They don’t require medical underwriting, nor do they refuse coverage due to any pre-existing health conditions.

Affordable Monthly Payments

Medicare Advantage plans adopt a “pay-as-you-use” model. Although this implies you’ll encounter copays and coinsurance fees, it also accounts for their attractively low premiums. It’s not uncommon to find Medicare Advantage plans in North Carolina boasting $0 monthly premiums. This stands in contrast to Medicare Supplements, which typically charge upwards of $100 monthly just for maintaining the coverage.

Capped Yearly Expenditure

Relying solely on Original Medicare (Parts A and B) exposes you to limitless out-of-pocket expenses. For instance, while Part B might cost you a mere 20% coinsurance, this can sum up to a significant amount if you require intensive medical care. On the other hand, Medicare Advantage plans put a limit on out-of-pocket costs, commonly referred to as MOOP (Maximum Out-of-Pocket). While individual plans may vary, most have MOOPs ranging from $2,000 to $5,000 annually.

No Age-Related Premium Hikes

Medicare Supplement premiums typically increase as beneficiaries age, with individuals in their mid-70s or beyond often facing Medigap premiums upwards of $300. Medicare Advantage, on the other hand, steers clear of age-related premium increases. Though these plans might adjust premiums due to factors like inflation or healthcare costs, your age remains a non-factor. This ensures you don’t face higher costs solely because you’ve gotten older.

Streamlined Coverage

The allure of Medicare Advantage lies partly in its streamlined approach. Say goodbye to juggling multiple insurance cards; with Medicare Advantage, just one card suffices. In the absence of Medicare Advantage, you’d likely need separate cards for Original Medicare, Medicare Supplement, Part D, and perhaps even dental insurance. With Medicare Advantage, all these layers of coverage are encapsulated in one convenient package.

Woman asking why someone would enroll in Medicare Advantage

Added Perks

The extra benefits most Medicare Advantage offer is another attractive feature. Whereas Original Medicare (even supplemented with a Medigap plan) won’t cover vision, dental, or hearing services, nor prescription drugs, Medicare Advantage bridges these gaps. Many plans go above and beyond, throwing in perks like gym memberships, allowances for over-the-counter items, home-delivered meals, and even transport services. Every plan is different, so be sure to consult your Medicare advisor to find out the specific details of a Medicare Advantage plan you’re considering.

Flexibility to Change Plans

Unsatisfied with your existing Medicare Advantage offering? No worries. You have the option to switch during the Medicare Annual Election Period (October 15 to December 7). And let’s not forget: there’s no underwriting hassle to contend with. We always advise beneficiaries to reassess their Medicare plans during the AEP. At Carolina Senior Benefits, we’re here to assist in scouting for the most suitable coverage for you.

Diving Deeper into Medicare Advantage

Our discussion on Medicare Advantage has only begun. Making an informed decision demands a thorough understanding of its benefits and potential drawbacks. For many, Medicare Advantage proves to be a suitable choice.

Interested in exploring Medicare Advantage plans in North Carolina? Reach out to Carolina Senior Benefits today!