Have A Medicare Advantage Plan? Time For A Check-Up.


Medicare Advantage Plans are the most rapidly growing segment of Medicare coverage.  These private insurance plans do more than take the place of “original” Medicare.  In addition to providing all the benefits of Medicare, Advantage Plans deliver an assortment of other valued healthcare services that may include gym memberships, vision, dental and hearing services, over-the-counter allowances, home-delivered meals and utility subsidies. 

The appeal driving this growth in Advantage Plan enrollments are the low premiums for coverage that is similar to the HMO plans offered by employers during the pre-retirement years.  In many markets, these wide-ranging Advantage benefits require no monthly premium.

As with everything, rich benefits come with a trade-off: delivery of these benefits is provided by a specific local or regional medical group, along with other contracted providers. 

The enrollee’s choice of low-cost Advantage coverages is a choice to get medical services from the providers contracted with that plan.

Often this trade-off is a problem for seniors when an illness calls for unique specialty services that may not be readily available from among the plan’s contracted medical providers.  While this can be a drawback to enrollment in an Advantage Plan, coverage modifications can be made during the annual Advantage Open Enrollment period between January 1st and March 31st.

Since Medicare plans change every year, these 3 months are a perfect time for a coverage check-up. 

If a different medical group is better suited to meet medical needs or preferences, the enrollee can choose new providers; if the Advantage Plan’s drug formulary has increased the cost of maintenance medications, a different plan’s formulary may have with lower costs; if another plan has a unique benefit that isn’t offered in the current plan, changing plans may be important.

In short, January 1st to March 31st is the perfect time to review Advantage coverages and keep your client well-served.  Our Medicare Specialists are available to support you through each phase of a Medicare fact-finding and sales process.  Contact us today!