What to Consider When Choosing Between Traditional Medicare, Medicare Advantage

Medicare Advantage and Traditional Medicare both have their own advantages and disadvantages. Individuals, particularly those aged 65 years of age and older or those retiring, should consider the differences in these insurance plans before deciding on a cover.

So, what are the basic differences in the two plans?

Medicare Advantage plans are managed by private insurance companies that receive payments from the federal government to offer benefits to individuals in their programs. On the other hand, traditional Medicare is a national program that offers benefits under Medicare.

What factors should older individuals and their caregivers think about before they choose Medicare Advantage or traditional Medicare plans?

Unlike traditional Medicare, Medicare Advantage includes vision and dental care in their plans. Some even include hearing. Medicare Advantage also provides debit cards that enable patients to acquire over-the-counter drugs.

However, some of the plans offered under Medicare Advantage have narrow networks. This is different from traditional Medicare, which allows patients to visit any hospital, any doctor or any home health agency in the United States.

It is important to note, however, that Medicare Advantage provides more than 40 different plans, all of which differ in benefits, drugs on the formulary and provider networks.

If an individual is under a preferred provider organization (PPO), they will have to pay extra if they are to be treated out of their network. On the other hand, if one is under a health maintenance organization (HMO), they may end up paying 100% out of their network. This is crucial, particularly for older individuals who travel for extended time periods in different locations.

So, what other issues should one consider?

Enrollees are advised to review networks annually on Medicare Advantage, which is somewhat burdensome. It doesn’t help that comparing networks on different plans isn’t an easy feat. In the event that a considerable change occurs mid-year, individuals do have the option of disenrolling and enrolling in another plan.

Another issue to consider is previous authorizations under Medicare Advantage. These requests increase time taken from hospitals and doctors’ offices by and negatively influence the care patients get as well. While these authorizations help keep healthcare costs in check and prevent patients from undergoing unnecessary procedures and testing, they also delay medical care, which may deter individuals from obtaining the care that they should get from a doctor.

From the above, one can see that both insurance plans have their own benefits and downsides. Despite this, individuals making decisions on health insurance coverage when healthy should also understand the importance of considering unexpected circumstances that may occur in the future.

It would also help to contact specific Medical Advantage companies such as Astiva Health that are operating in your area so that you can make an informed decision while choosing between traditional Medicare and MA plans.

NOTE TO INVESTORS: The latest news and updates relating to Astiva Health are available in the company’s newsroom at https://ibn.fm/Astiva

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