The process for picking a health insurance plan can be overwhelming. How do you know if you’re picking the correct plan? Will the ‘cheaper’ monthly premium cause issues when you’re trying to seek care? What if you need physical therapy, will it cover that? When people are selecting their insurance plans, they need to balance out the monthly premium compared to what their potential out of pocket costs could be.
I have first hand experienced this working in aging services. I work in a facility where we primarily serve seniors who fall in the low-income bracket. Many of these seniors have opted for a Medicare Advantage plan because of their limited financial resources each month. A Medicare Advantage plan are sometimes called “Part C” or “MA Plans,” and are offered by private companies approved by Medicare. Medicare pays these companies to cover Medicare benefits. If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage (Medicare, 2015).
Medicare Advantage plans have several positives that draw the consumer in. Some of them are: convenient coverage plans (all your coverage is through one plan), personalized plan structure (many different plans are offered that you can tailor to your individual situation), cost saving opportunities & coordinated medical care (Lockett, 2019). Some disadvantages are: limited service providers, overwhelming number of plans offered (making a decision could be difficult), additional costs for coverage & state-specific coverage (Lockett, 2019).
I personally don’t believe that Medicare Advantage plans really serve individuals better; especially the elderly clients. The residents that I have known to select an advantage plan is because they don’t pay a monthly premium. Which is very attractive, especially to a senior that has low income. Where I have seen a gap widen is when this resident needed outpatient physical therapy services. The resident had to pay a $35 co-pay for each therapy visit. This amount alone in one month is more costly than if they would have decided to keep their traditional Medicare plan. So while it may seem like an advantage plan is a good choice in the short term it does provide significant financial challenges when the person does seek care.
I have first hand experienced this working in aging services. I work in a facility where we primarily serve seniors who fall in the low-income bracket. Many of these seniors have opted for a Medicare Advantage plan because of their limited financial resources each month. A Medicare Advantage plan are sometimes called “Part C” or “MA Plans,” and are offered by private companies approved by Medicare. Medicare pays these companies to cover Medicare benefits. If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage (Medicare, 2015).
Medicare Advantage plans have several positives that draw the consumer in. Some of them are: convenient coverage plans (all your coverage is through one plan), personalized plan structure (many different plans are offered that you can tailor to your individual situation), cost saving opportunities & coordinated medical care (Lockett, 2019). Some disadvantages are: limited service providers, overwhelming number of plans offered (making a decision could be difficult), additional costs for coverage & state-specific coverage (Lockett, 2019).
I personally don’t believe that Medicare Advantage plans really serve individuals better; especially the elderly clients. The residents that I have known to select an advantage plan is because they don’t pay a monthly premium. Which is very attractive, especially to a senior that has low income. Where I have seen a gap widen is when this resident needed outpatient physical therapy services. The resident had to pay a $35 co-pay for each therapy visit. This amount alone in one month is more costly than if they would have decided to keep their traditional Medicare plan. So while it may seem like an advantage plan is a good choice in the short term it does provide significant financial challenges when the person does seek care.