3 Things to Know About Medicare Advantage

When it comes to Medicare Advantage, I think there are three very important things to be aware of before enrolling in a plan.

1. They Are Mostly HMO’s – The All-In-One Medicare Advantage plans are mostly HMO plans where you need to choose a primary care doctor and will need referrals to go see specialists. Here in Orange County and LA County, probably close to 95% of Medicare Advantage Plans are HMO’s. Some people aren’t aware of this before enrolling.

2. You May be Asked Medical Questions to Get a Supplement – When you are first turning 65 or coming off group insurance and enrolling into Part B, you can choose any type of Medicare plan that you want with no medical questions asked. After you choose Medicare Advantage, you may then be asked medical questions if you want to leave your plan and get a Supplement which would allow you more freedom of choice. We hate to see people get stuck on Medicare Advantage when they need the most medical attention.

3. Many Plans Are Zero Premium But Not Completely Zero Premium – Many plans have $0 additional premium to pay to be enrolled but what many are not aware of is that these Medicare Advantage plans are subsidized by the government. Centers for Medicare Services sends close to $1000/month to the Medicare Advantage companies for every person that is enrolled in that type of plan. If funding for these Medicare Advantage plans ever change, that cost could be passed along to the member. Many plans are zero premium now but may not always be zero premium.

Those are the three things I think people should know about Medicare Advantage before enrolling in a plan.

Let me know what you think!

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One Comment

  1. It’s interesting to know that almost all Medicare advantage plans are HMOs. I’d like to enroll soon because there are times when I feel a bit weak when I do too much physical activities. That might be a sign that I might need to get prescribed some maintenance medicine soon enough.

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