Because of the way Congress funds Medicare Advantage plans, it is possible for them to offer benefits that Original Medicare does not. If a plan is coming in below what average projected cost for a Medicare beneficiary in its service area, it can use the savings to offer additional benefits such as eyeglasses, dental services, gym memberships, hearing aids, premium reductions, extra drug benefits, and the like.
Medicare Supplement plans, in contrast, offer only extra payments towards what Medicare already covers. Medicare Supplement plans do not have out-of-pocket limits.
Both Medicare Advantage and Medicare Supplement plans vary widely in cost, depending on exactly what they cover and their service area. The average Medicare Advantage premium in 2021 is $25 per month, although some have a zero premium and others have premiums over $100. The average premium for a Medicare supplemental plan in 2021 is $134 – $205, with higher premiums for older ages.
Part B Premium Refunds
All Medicare Advantage plans require beneficiaries to have enrolled in Medicare Part B before they enroll in the plan. Some of them refund all or part of the Part B premium to their members.
Choice of Providers
Virtually all Medicare Advantage plans have “panels” of providers whom their beneficiaries are required or encouraged to use. Those that are organized on an open panel model allow members to use any provider who contracts with the plan. Those organized as a Preferred Provider Organization (PPO) let members use any provider but do not limit what non-preferred providers can charge. Those that are organized on a Health Maintenance Organization (HM) model will not pay for providers outside their panel.
If keeping your doctor is a concern to you, make sure that they are part of the panel of the Medicare Advantage plan you are considering.
Medicare Supplement plans, in contrast, never limit choice of providers.
For more information, give us a call today at 405-694-0892.