Top Medicare Advantage Questions -- Answered By Your Friends at Healthy Access

Medicare is so misunderstood by Americans and some of that is the myth that Medicare is free health care or universal health care. It’s not. So let's try to answer some of the top questions to clear things up. 

What are the negatives to a Medicare Advantage plan?

Are Medicare Advantage plans too good to be true?

What is a key advantage of Medicare Advantage plans?

What is the best way to compare Medicare Advantage plans?

We bet you’re asking these and more questions now that you’re getting close to 65 years old. And you thought that Medicare would make this simple. Ha! But that’s why you have us. We’re here to help you make the right choice.

There are negatives to a Medicare Advantage plan if you plan to move about the country while you’re retired or relocate entirely. The plan costs and coverages are based upon where you live. And, inflation will have an effect on those. 

“Health care inflation has been running about double the rate of general inflation. HealthView Services, a research and consulting firm, expects annual health care inflation to run an average of 5 percent to 5.5 percent through most of the coming decade.” NY Times (2019)

Will the Cost of Living Adjustment (COLA) Really Keep Up with Health Care Inflation? 

No, it’s unlikely that COLAs will keep up with actual inflation, let alone health care inflation. Inflation is no joke and if you’re 45 years old or older you’d better be thinking about how you’re going to pay for your health insurance premiums and out of pocket costs. We’d bet that Dave Ramsey and Suze Orman have some advice on their podcastsl. 

With that said, HealthView Services has sobering information for GenXers and Baby Boomers in their report, “2022 Retirement Healthcare Costs Data Report Brief: The Long-Term Impact of Short-Term Inflation.” Did you figure you’d need a cool 1.7 mil just for “lifetime retirement healthcare costs?” That’s on top of your retirement account needed to maintain the lifestyle you plan for. Yikes!

"With inflation rising to a 40-year high of 7.9% in 2022, the impact on future expenses will be significant. The 2022 Medicare Part B premium increase of nearly 15% (a record-high $518 annually for a married couple) may be a harbinger for future healthcare cost increases." HealthView Services 

Are Medicare Advantage Plans Expensive?

Expensive is a relative term. Some people think COBRA is expensive. It’s not. Sure, there’s a processing fee, but you – as a former employee – are not used to having to PAY for that premium. Furthermore, if your premium is $600, how much do yu have to earn for your paycheck to NET $600? About $800

So, is Medicare Advantage expensive? Maybe. But not anymore expensive than health insurance is in this marketplace with the current buying power of the dollar. Is it a lot of money in comparison to a fixed income? Likely the answer is yes – especially if you haven’t planned for this. (This is your time to plan for retirement, GenX). 

Medicare Advantage can cost more than what feels “free” with Original Medicare. You know what costs more than that? Not being covered for doctor’s appointments and prescriptions. 

“If you’re like a lot of people preparing to enroll in Medicare, you may be used to your employer picking up most of your health insurance tab. But as you approach age 65, you may be quite surprised to learn how costly coverage can be.” Fidelity

Does Medicare Advantage Include Vision and Dental? 

Some Medicare Advantage plans may include things like vision, dental, and hearing. But don’t presume they all do. This is why talking to a qualified insurance broker is important. Your coverage needs are not the same as Sally’s or Juan’s down the street. You’re you and insurance is personal. We like to think it should all be the same, but that isn’t necessarily true. We wish we could give you a list of plans that have those included. However, it depends upon where you live – not just state, but your zip code.

“Some Medicare Advantage plans, for example, cover vision or dental care. If you have a history of complex dental or eye health issues, or have reason to believe you will soon need extensive care, it makes sense to choose a plan that includes these services.” WebMD

Does the Plan Have a Network of Providers that I need?

If you do have specific health issues, always read the plan docs. Likely, they’re about as long as War and Peace, but with the help of an independent insurance broker, we can give you the specifics to look for in the docs. For example, if you’re diabetic, you’ll want to ensure your plan covers nephrology and maybe even endocrinologists as well as has those providers listed in the directory near you. If you have arthritis, you’ll want to see a rheumatologist, etc.

I like the Plan I’m on with my Employer. Do I have to Enroll in Medicare?

Yes and no. It also depends upon if you’re the primary insured or if you’re on a plan provided by your spouse’s workplace. Isn’t it annoying how confusing Medicare is, let alone Medicare Advantage? So many questions have “it depends” answers and we apologize for that. Know that you may not always have a choice.

“You are required to take full Medicare benefits – both Parts A and B – at age 65 if your company has less than 20 employees.” AARP Medicare Plans 

Find a Plan That Fits Your Life

Healthy Access takes pride in consumer education and healthcare services to help ensure every person researching and enrolling in Medicare receives expert education, decision support, and trusted activation options. Are you ready for a free, no-obligation quote?

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