What should I consider regarding Medicare Advantage plan costs?

  • February 26, 2018
Q: What should I consider regarding Medicare Advantage plan costs?

A: When considering and comparing Medicare Advantage plans you need to look at both monthly premiums and out-of-pocket costs carefully.  If you are generally healthy, you might look to save on premium and choose a plan that has higher out-of-pocket service coverage costs.

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But if you require a lot of tests and diagnostics for diabetes care for instance, you may be better off choosing a plan with lower coinsurance or copay requirements.  When comparing plans, use your best judgment to chart out all costs you are likely to encounter over a plan year.

When comparing premiums, keep in mind that you’ll have to pay your Part B premium (an average of $130/month in 2018) in addition to whatever the premium is for the Medicare Advantage plan. For most people, the Part B premium is simply deducted from Social Security checks. But enrollees who aren’t receiving Social Security will pay Medicare directly for Part B coverage.

In addition, be aware that networks vary considerably from one Medicare Advantage plan to another, and from one year to the next. So if it’s important to you to be able to continue to see your current doctor, make sure you double check the network of each plan you’re considering.

If you prefer a wider network, you can disenroll from Medicare Advantage (during the annual open enrollment, from October 15 to December 7, or during the annual Medicare Advantage disenrollment period, from January 1 to February 14) and switch back to Original Medicare. With Original Medicare, you can see any provider in the country who is contracted with Medicare.

Network issues can be particularly important for seniors who spend the year in multiple locations to be near family or follow favorable weather.  If you live in more than one place during the year, be sure that the Medicare Advantage plan you’re considering has network providers in both areas. If not, Original Medicare might be a better option.

Be aware that Medicare Advantage drug formularies (covered drug lists) change frequently too, so compare your medications against the formularies for the plans you’re considering.

This article will walk you through several questions that will help you determine whether you’d be better off with Medicare Advantage or Original Medicare with supplemental coverage.