What Are Medicare Advantage Plans?

Medicare Advantage Plans (Medicare Part C) are offered by private insurance companies approved by Medicare to provide all your Part A and Part B benefits. These plans often include additional benefits not covered by Original Medicare, such as vision, dental, hearing, and prescription drug coverage. Many Medicare Advantage Plans operate as HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations), requiring you to use network providers for non-emergency care.

Medicare Advantage Plans typically have lower monthly premiums than Medicare Supplement Plans but may require copayments, coinsurance, and deductibles when you receive care. These plans also come with annual out-of-pocket maximums that protect you from catastrophic healthcare costs in a given year. The structure of these plans means they work well for individuals who prefer predictable costs and are comfortable with network restrictions.

How Medicare Supplement Plans Differ

Medicare Supplement Plans, also known as Medigap policies, work alongside Original Medicare (Parts A and B) to fill “gaps” in coverage. Unlike Medicare Advantage Plans, which replace Original Medicare, Supplement Plans complement it by covering expenses like deductibles, copayments, and coinsurance that you would otherwise pay out-of-pocket.

There are currently ten standardized Medicare Supplement Plans (labeled A through N), each offering different levels of coverage at varying price points. The most comprehensive plans (such as Plan F and Plan G) cover almost all out-of-pocket costs but come with higher premiums. With a Medicare Supplement Plan, you can visit any doctor or hospital that accepts Medicare without network restrictions, making these plans attractive for those who travel frequently or want maximum provider flexibility.

Understanding Medicare Open Enrollment

Medicare Open Enrollment occurs annually from October 15 to December 7. During this critical period, Medicare beneficiaries can review their current coverage and make changes for the following year. This enrollment period allows you to:

• Switch from Original Medicare to a Medicare Advantage Plan

• Change from one Medicare Advantage Plan to another

• Return to Original Medicare from a Medicare Advantage Plan

• Join, switch, or drop a Medicare prescription drug plan (Part D)

• Add a Medicare Supplement Plan when returning to Original Medicare

Making changes during Open Enrollment ensures your coverage will begin on January 1 of the following year. It’s important to review your plan annually, as insurance companies often adjust premiums, drug formularies, provider networks, and benefits from year to year. What worked well for you previously may not be the best option going forward as your health needs change.

Comparing Medicare Health Insurance Options

When evaluating Medicare health insurance options, consider your personal healthcare needs, budget constraints, preferred providers, and prescription medications. Original Medicare with a Supplement Plan generally offers more provider freedom but at higher monthly premium costs. Medicare Advantage Plans typically have lower premiums but more restricted networks and potential out-of-pocket costs when services are used.

Your chronic conditions, frequency of doctor visits, prescription medications, and travel plans should all factor into your decision. For example, if you spend winters in another state, a Medicare Supplement Plan might better accommodate your needs than a regionally-based Medicare Advantage Plan with a limited network.

Medicare Health Insurance Cost Comparison

The cost of Medicare coverage varies significantly based on the type of plan, your location, and the level of coverage selected. Below is a general comparison of potential costs associated with different Medicare options:

---

Plan Type	Monthly Premium Range	Out-of-Pocket Maximum	Provider Restrictions	Additional Benefits
Original Medicare (Parts A & B)	$174.70 (Part B premium, 2024)	No cap	Nationwide coverage	Limited (no vision, dental, etc.)
Medicare Advantage Plan	$0-$100+ (plus Part B premium)	$8,850 or less (2024)	Network restrictions	Often includes vision, dental, hearing
Medicare Supplement Plan	$50-$400+ (plus Part B premium)	Varies by plan	Nationwide coverage	None (covers Medicare costs only)

---

Prices, rates, or cost estimates mentioned in this article are based on the latest available information but may change over time. Independent research is advised before making financial decisions.

Finding Support with BeneSelect for Medicare Decisions

BeneSelect and similar insurance brokers specialize in helping beneficiaries navigate their Medicare options. These services provide personalized assistance in comparing plans based on individual health needs, budget considerations, and provider preferences. Working with an independent broker can provide unbiased information about multiple insurance carriers rather than being limited to one company’s offerings.

Insurance brokers like BeneSelect typically offer services at no direct cost to you, as they are compensated by the insurance companies when you enroll. They can help explain complex Medicare rules, analyze how different plans would cover your specific prescriptions, and assist with the enrollment process. For many seniors, having an advocate to help navigate these important healthcare decisions provides valuable peace of mind during the sometimes overwhelming process of selecting Medicare coverage.

Medicare health insurance decisions should be revisited annually as your health needs, plan offerings, and personal circumstances change. Taking advantage of the annual Medicare Open Enrollment period ensures you maintain appropriate coverage that balances cost, convenience, and comprehensive protection for your healthcare needs.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.