All 55 Plus, Medicare

Why Medicare Advantage is Popular

by Author Barbara Nevins Taylor

 

It turns out, Medicare Advantage is popular for a growing number of Baby Boomers.  That may be because the monthly premium is only about $35 and there’s a full range of healthcare services included.

 The Kaiser Family Foundation’s latest report says that 15.7 million Americans, or 30 percent of everyone on Medicare, is in a Medicare Advantage Plan.

If you’re not familiar with the options available, here’s a quick look it how it works.  When you turn 65 you automatically get Medicare Part A.

Part A Covers

  • Hospitalization
  • Nursing Care
  • Nursing Home Care
  • Hospice
  • Home Health Services

If you are not working and covered by your employer’s insurance, you must sign up for Medicare Part B within three months of your 65th birthday. There’s more about this in Boomers Part B and Costly Mistakes.

Part B covers:

  • Doctor Visits
  • Routine Medical Care
  • Preventive Care
  • Ambulance Service

Once you sign up for Part B, you confront a range of options because Medicare only covers 80 percent of your health care costs. If you choose Medicare Advantage it covers the other 20 percent. 

The government pays private insurers to offer Medicare Advantage plans that are run like  HMOs and PPOs. That means you get all your health care from doctors, hospitals and providers in your insurer’s network.

 As a result of  Affordable Care Act, which became law in 2010,  Medicare Advantage insurers’ payments were reduced and they’ve been encouraged to provide more  benefits. So you might find a plan that offers:

  • Wellness benefits
  • Payments for vision checks and eyeglasses
  • Gym memberships
  • At-home visits from healthcare professionals
  • Part D drug benefits.

The Kaiser Foundation says, “In 2014, 83 percent of Medicare Advantage plans offer prescription drug coverage.

Kaiser also found premiums in Medicare Advantage plans average $35 per month in 2014 compared to $39 in 2011 and $44 in  2010.

The downside is that out-of-pocket spending limits are rising. 44 percent are enrolled in plans with limits over $5,000.

However, Medicare Advantage plans are required to limit their out-of-pocket costs for services covered under Parts A and B:

  • $3,400 is recommended
  • $6,700 is the maximum  

 watchmoreFind out about Medicare Supplemental plans: Figuring Out Medicare Choices