The popularity of Medicare Advantage plans continues to grow. In 2024, 54% of Medicare beneficiaries chose to enroll in a Medicare Advantage plan, up from just over 50% in 2023. Why are so many seniors choosing this coverage? Here are five advantages seniors say they like about these plans.
1. Comprehensive Coverage with One Monthly Premium
Many seniors like the ease and simplicity or Medicare Advantage plans. Unlike Original Medicare, enrollment in an Advantage plan provides Medicare parts A and B, as well as Part D drug coverage, all rolled into one plan with one monthly premium.
2. Affordability
Many Medicare beneficiaries find Medicare Advantage plans to be more affordable. Insurers in many areas offer plans with low monthly premiums, including $0 premium plans and Part B give back plans that help pay the enrollees Part B premium. Advantage plans also come with an annual out of pocket maximum. This maximum amount, set yearly by the federal government, caps the amount an enrollee will have to pay out of pocket in any given year. Many enrollees like knowing there is limit on their annual expenses.
3. Extra Benefits
Seniors often cite the extra benefits they receive from a Medicare Advantage plan as the primary reason for choosing this type of coverage. These benefits are not included in traditional Medicare coverage. Benefits vary between insurance carriers, but most plans include dental, vision and hearing coverage. Some plans may also include additional benefits such as:
- Gym memberships and wellness programs
- In-home meal delivery after hospital stays
- Massage and chiropractic benefits
- Over the counter allowance to purchase OTC products
- Gift card rewards for completing annual preventive services
4. Specialized Care for Chronic Health Conditions
94% of older adults have at least one chronic health condition, while 78.7% have two or more. Many Medicare Advantage plans offer extra benefits for those with chronic health conditions including in home visits with a nurse and free transportation to medical appointments.
Some individuals with chronic conditions may qualify for a Chronic Condition Special Needs Plan (C-SNP) that focuses on their specific condition. There are 15 different chronic conditions covered by C-SNP’s. These special Medicare Advantage plans may offer lower drugs costs for the medications required to treat the chronic condition, access to hospitals and doctors who specialize in the condition and lower copays for these visits. The C-SNP plan may provide access to a Care Coordinator who works with the enrollee and their doctors to help support and coordinate the many aspects of their medical care including help setting up appointments and managing prescriptions. These plans can help individuals with chronic conditions experience better health outcomes and improved quality of life. Not all C-SNP plans are available in all areas.
5. The Five Star Rating System
Medicare Advantage plans are rated annually by CMS on a variety of measures. This five star rating system scores plans from one to five stars, with five stars being excellent. Medicare beneficiaries find the rating system helpful when shopping for an Advantage plan. It provides transparency and can help them make informed decisions about their plan choices based on quality of care and customer service. Plans with consistently high star ratings typically retain and attract more members and are more financially stable. While star ratings are not the only factor to consider when choosing a plan, it does help seniors know how well a plan is performing.
Medicare Advantage Plans Aren’t Right for Everyone
Everyone’s individual circumstances are different, and Medicare Advantage plans aren’t right for everyone. One primary factor to consider when choosing a Medicare Advantage plan is that you are required to use the doctors and hospitals within the plan’s network. Depending on the type of Advantage plan, there may be no out of network coverage, or that coverage may come at a higher out of pocket cost.
Medicare Advantage plans change every year so if you do enroll in one of these plans it’s important to review your Annual Notice of Change that comes every September from your insurance carrier. If your plan changes, or your circumstances have changed, you may need to shop around for different coverage.
A Medicare Agent Can Help
If your plan is no longer a good fit, a licensed Medicare agent can help you review your options and find the Medicare coverage that is right for you. They can help you compare benefits and out of pocket costs. They can help you determine if you qualify for a special enrollment period and can help you find and enroll in a new plan.
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