As people approach the age of 60-65, a crucial decision awaits them – choosing the most convenient and budget-friendly Medicare plan that aligns with their medical needs and history.
Due to the extensive coverage and other perks, Medicare Advantage Plans stand out as the most desirable option. Medicare Advantage plans are basically those plans that are offered by private companies but are approved by Medicare.
Medicare Plan A provides hospital coverage, whereas Medicare Plan B provides medical services. There are 4 main types of Medicare Advantage plans that an individual can choose, but the question is which one is most suitable and how to identify it.
There are certain factors that a person needs to consider while selecting the best Medicare Advantage plan. In this blog, we aim to shed light on critical factors that should get the highest attention in order to select the desirable Medicare Advantage plan and make a good decision for the future.
Cost and Budget
Your budget and the cost of the plan are important factors to consider while selecting the Medicare advantage plan. Consider the monthly premiums, plan A and B premiums, yearly deductibles, copays, coinsurance, out-of-pocket etc., of the various plans and choose the one that aligns with your budget and financial situation.
It’s important to check the premiums as some plans have low premiums, which means a person has to pay a high amount later on. The cost basically depends on the plan, the services you need, the frequency of taking Medicare services and the need for a specialist or not.
Medicare Advantage plans generally have a yearly limit for out-of-pocket costs, and when the limit is reached, the charges for covered services stop for that year. This is considered a budget-friendly and reliable option for any individual.
Coverage and Benefits
It’s crucial to consider what the plan truly covers because it needs to cover the kind of medical care you could need in the future. Ensure that the Advantage plans cover every type of service included under the original plan plus some additional benefits like dental, hearing, and vision.
Besides that, the plan should include the required drugs, medicines, treatment and medical services you will require according to your medical conditions.
Some Medicare Advantage plans also include fitness memberships, in-home care service and safety devices, mental health support, and transportation costs, which can be termed as extra advantages that can further reduce the overall cost and provide the best support in every manner.
Prescription Drug Coverage
If you take daily medication, make sure that the plan covers your prescription drugs. Check the copays, drug limits, and other deductibles. Generally, the Advantage plan provides drug coverage, but in case it does not provide it, it’s better to take the separate plan D.
If the plan includes drug coverage, check out the cost of it and whether it matches your desired budget or not. Some plans have copays, some have premiums, and some have deductibles. The cost depends on the type of drug you need, and it changes from year to year.
It’s crucial to check the latest drug list covered under the plan and ensure its availability in the purchased Medicare plan. Check out Humana Medicare Advantage plans 2024 and learn and compare the various plans to select the most suitable one. Ensure that the plan does not put any restrictions on the drug coverage.
Medicare Star Ratings and Reviews
Before purchasing or choosing anything, it’s vital to check the ratings and reviews provided by the current or previous customers. The advantage plan has a 5-star rating system, in which a customer can give stars ranging from 1 to 5 depending on the various factors.
The factors include customer support and services, network providers, chronic condition management, travel coverage, drug coverage etc. The plan’s quality ratings and positive reviews depict that the plan is up to the mark, whereas low ratings are like a red flag which depicts a person should consider some other plan for his Medicare needs.
Network of Providers
Check if the plan covers your doctor, physician, specialists, clinics, hospital and other healthcare facilities. Ensure that those doctors accept the coverage and are willing to treat new patients with advantage coverage plans.
Check this on their website in the benefits and cost section and cross-check it with the doctors and ask them to verify their participation. Choose a plan with a broader network so that you will get more options for hospitals and doctors, whereas a small network will limit your options.
These are in-network providers that are covered by the plan and cost less than out-of-network providers. Out of network providers usually charge hefty copays, coinsurance, and other fees, which raises the overall cost.
If you are a frequent traveler who spends time in different states, ensure that the plan extends its services outside the service area. It should not be bound by a country or state.
Advantage Medicare plans through PPO plans extend their coverage even outside its service area and provide treatment anywhere in the US using out-of-network benefits. Apart from that, HMO plans also ensure out-of-network coverage but only in case of emergencies.
Due to any emergency while travelling, you can take benefit of this and get treatment in any hospital under the coverage. In a normal case, even an advantageous plan does not cover beyond the country’s borders. You have to purchase the additional travel Medicare insurance plan to cover the medical emergencies outside the country.
Maximum Out of pocket Limit
The out-of-pocket limit is essential to consider as it provides financial aid against higher healthcare expenses. It’s the money that the person has to pay as an additional cost out of his pocket for medical services during a year.
Once that maximum out-of-pocket limit is reached, the Advantage plan will cover the rest of the costs for the remaining year. To analyze the overall financial protection provided by the plan, it is critical to evaluate not only the monthly premium and out-of-pocket costs but also the Maximum out-of-pocket limit.
Medicare Advantage plans require careful consideration of the important factors. By evaluating these factors, a person can make a more informed decision about the Medicare Advantage plan that provides maximum coverage at a lesser cost and ensures a secure future.
Checking travel and maximum out-of-pocket coverage to protect yourself from the high unexpected emergency costs due to out-of-coverage network treatments.