What are the pros and cons of a Medicare advantage plan?

Answer 1

Advantages: The advantages of Medicare is the low costs and additional benefits offered. The managed health care insurance company charges a monthly premium to become a member Medicare pays most of this premium to become a member, if not all of it, for it's members. The additional benefits can include vision and dentdal coverage as well as prescription drug coverage.

Disadvantage: Limited network providers.

Answer 2

A Medicare Advantage Plan basically replaces your use of Traditional Medicare. You still must pay your Medicare Part B premium that is automatically deducted from your Social Security check, that will not stop when you purchase the Medicare Advantage Plan though there are plans have may reimburse a portion of your Part B Premium. The following types of Medicare Advantage plans are available, but not always available depending on your county and state of residence:

HMOPros can be zero or very low cost to you per month, predictable co-pays like $10.00 or $15.00 for doctor's office visits, and lower cost hosptilization than Traditional Medicare, no deductibles, and most will include your Medicare Part D Prescription Plan.

Cons can be a restricted network of doctors that you must use, no maximum out of pocket limits, and some plans may resort to the old "referrals" to see a specialist.

PPOPros can be low cost to you per month, predictable co-pays like $15.00 or $20.00 for doctor's office visits, you can go in or out of network, no deductibles when you stay in network, no referrals for specialist, lower cost hosptilization than Traditional Medicare, an established maximum out of pocket, and most will include your Medicare Part D Prescription Plan.

Cons can be if you do go out of network you'll pay a deductible first before the cost is split by a percentage between you and the insurance company.

PFFSThis is a "Private Fee For Services" Plan.

First the Cons: The single most important thing to remember about PFFS is the fact that you must contact the doctor or hospital FIRST to see if they take the plan. Even before you make an appointment to see a doctor, the doctor must tell you that they do indeed accept the terms and conditions of the plan. The doctor also has the choice not to accept the plan on a per visit basis. Meaning, the doctor may accept the terms and conditions on the first visit, but may not on the second.

The pros are similar to the PPO, it works basically the same. The monthly premiums are typically higher than the PPO, but less than adding a supplement.

ONE MORE THING!Now, there are pros and cons when comparing the Medicare Advantage Plans to Traditional Medicare with Medigap, or a Medicare Supplement attached to it. Medigap, also called a Medicare Supplement, basically pays the portion of medical expenses that Medicare expects you to pay. Medicare is an "80/20" plan, meaning Medicare pays 80% of the bill and you pay 20% of the bill. Medigap can pay the 20% for you. Depending on which Medigap plan you choose, the plan can also pay the (2009) $1068.00 hositalization deductible for you and the $135.00 doctor's office deductible for you. The only problem with Medigap is the monthly premiums range anywhere between $120.00/month to $300.00/month and they do not include drug coverage.

Here's the latest publication from Medicare that explains some more details at links: