There are both pros and cons of Medicare Advantage plans and our health care agents here at Florida Healthcare Insurance are happy to help you determine whether a Medicare Advantage plan matches your healthcare needs. For Medicare beneficiaries, Medicare Advantage plans have become increasingly popular over the years, especially in Florida, and we’ve compiled some helpful information on what you need to know before choosing your Medicare Advantage plan. Health care costs are rising, and it’s important to determine whether you need to lower your out of pocket costs, whether or not your Medicare coverage has a prescription drug plan, or whether private insurance companies lower health care costs.
What is Medicare Advantage? Are Medicare Advantage plans available to Medicare Beneficiaries in Florida?
Yes, if for Medicare beneficiaries with a Medicare Advantageplan (versus a Medicare supplement plan), you must use Florida health care providers within the plan’s network. With Original Medicare coverage, or traditional Medicare, you use Medicare-approved providers of your choice. You can save money on your monthly premium on a Medicare advantage plan as opposed to purchasing a Medigap plan or supplemental coverage. A Medigap plan may not save money on monthly premiums like Medicare advantage plans free.
Let’s distinguish between Medicare Supplement plans and Medicare Advantage Plans. First, let’s start with understanding what Medicare Advantage is. You may have heard it coined as Medicare Part C. It is a private, Medicare-approved health insurance plan designed for individuals who are registered for both Parts A&B of Original Medicare. It combines Medicare coverage to be more than a Medicare supplement insurance plan for doctor visits, hospital care, and other medical services in one plan and out of pocket costs. This means rather than paying deductibles plus 20% (coinsurance) of your medical services with Medicare supplement plans, you will only be paying the plan’s copays.
Every penny you spend on Part A and Part B services is contributed towards your out of pocket costs or maximum. Once you hit that maximum, your Part C will pay 100% for the remaining year. Most Medicare Advantage plans offer a Florida Medicare Part D or prescription drug coverage. Let’s compare Medicare Advantage plans by looking at pros and cons of most Medicare Advantage plans:
Pros and Cons of Medicare Advantage Plans
Pros of Medicare Advantage:
- Medicare Advantage Plans provide Medicare benefits that may cost less than the Original Medicare coverage
- Medicare Advantage enrollees can receive additional Medicare benefits offered by the plan like coverage for hearing, dental services, vision, along with special discounts on certain health-related products, health care providers, and wellness programs and preventive services.
- You could be eligible for health benefits, subsidies on your monthly premium or out of pocket costs to help cover your prescription drug coverage and premiums!
- Medicare Advantage Plans may serve as a “one-stop” center for all your health and prescription drug coverage needs and limit out of pocket costs
Let’s take a look at some disadvantages of Medicare Advantage plans:
Disadvantages of Medicare Advantage Coverage:
- Cons of Medicare Advantage Plans may have is it may limit your freedom of choice in Florida health care providers
- Medicare Advantage Plans may require for pre-authorization and staying in-network can be lengthy, which can be challenging for those with chronic conditions or severe health needs
- Higher costs could arise for those facing serious illness
- Individuals could pay more out of pocket for service until they reach the plan cap
The Bottom Line
Overall, Florida Medicare Advantage plans are best for for health care coverage for healthy adults who prefer low premiums and are comfortable with managed care. Medicare Advantage plans have different rules, networks and health care providers, and enrollment periods and usually offer prescription drug coverage. Regardless of which plan you choose, remember you are always covered for urgent and emergency care. Most Florida Medicare Advantage plans include prescription medicine coverage, and benefits can differ from year to year, so it’s important to understand how a plan works before enrolling — which is why we’re here! We can shop to find you the best Medicare Advantage plan for your needs. We know how complicated the health insurance shopping process can be! We suggest speaking with one of our expert agents today to help see if a Florida Medicare Advantage plan is right for you!