Choosing a Medicare plan can be hard for many. One of the most common issues people face is deciding if they really need Medicare Advantage. And we don’t really blame them for it. It is a difficult decision indeed, especially when you don’t have the right knowledge. Today, we’re going to help improve your knowledge about Medicare Part C by putting some common Medicare Advantage misconceptions to rest, so you can make an informed decision and feel confident in it.
Common Misconceptions About Medicare Advantage
The world of Medicare Advantage is rife with myths and misconceptions. And the fact that the Medicare Part C plans are offered by a host of private insurance companies, and their offerings can vary, has much to do with it. Let’s look at some of the commonly prevailing wrong bits of information about Advantage plans and the facts behind them to help you develop a better understanding of these Medicare health insurance plans.
1. You cannot change your Medicare Advantage plan for life
This is far from the truth. In reality, you can switch to a different Advantage plan, or even return to your Original Medicare policy, during the Annual Election Period (AEP), which runs from October 15 to December 7 every year. The changes, however, become effective from the New Year, i.e. January 1st.
You may also qualify for a Special Enrollment Period (SEP) under special circumstances. These typically include those who live in move in, or move out of skilled nursing or long-term care facility, move to a different geographical location, or are released from jail.
The time duration and rules about what changes you can make in your health insurance policy differ for each Special Enrollment Period.
2. Medicare Part C doesn’t include vision, hearing, or dental coverage
This is true for Original Medicare and not for Part C. In fact, most these plans do include hearing, vision, and dental benefits. Some may even offer acupuncture, chiropractic, and fitness coverage.
3. It’s not easy to get your hands on drug lists when choosing an Advantage Plan with drug coverage
You can find drug lists for Medicare Advantage plans with Part D, called MAPD plans, and see if they cover your specific prescription drugs through Medicare online Plan Finder or directly contact the policy providers.
4. Advantage plans are only for people with good health
That’s not true. Just like you can’t be rejected for Original Medicare because have a pre-existing health condition, you can’t be denied an Advantage only because you’re not in the best of health. Even if you have a chronic disease, there are Medicare Advantage plans that offer disease management and care coordination.
You can now enroll in an Advantage plan if you have end-stage renal disease and qualify for Medicare, a positive change implemented at the beginning of 2021.
5. Medicare Advantage plans have small provider networks
This isn’t an absolute rule and can vary depending on the plan you choose. For example, Advantage HMO plans do have specific networks of providers, and you’re expected to work with them in most cases. Similarly, there are some plans that charge you less if you see a doctor in their network. However, many these plans allow you to see any healthcare provider.
If you work with a specific doctor, you can check the provider network for the Medicare Advantage plan you’re considering buying to find out if they are included in it.
6. With Medicare Advantage, you need referrals to see specialists
This is another condition that varies across different Medicare Advantage plans and is not a general rule, as commonly believed. In most cases, you don’t need referrals to see specialist doctors. However, if you have a Health Maintenance Organization plan, commonly known as an HMO plan, or a Special Needs Plan (SNP), you will need referrals for most specialty services, with the exception of a few routine yearly screenings.
7. All Medicare Advantage plans provide the same level of service
This is absolutely not true. Just like any other service, not all Advantage policy providers are the same. It is essential that you consider the reputation, rating, and reviews of the service provider along with the benefits and cost of an Advantage plan to make sure you receive top-notch services.
The Final Word
Medicare Advantage, also known as Medicare Part C, isn’t as complicated as it appears. What makes people really struggle with Advantage plans is that there are several different types of it. It may be a little confusing to know and remember all the benefits and conditions of various Medicare Advantage plans. This is where a Medicare expert can help!
We, at United Insurance, have a team of Medicare Advantage Experts on board who know it all about this health plan and can help you find the best Part C policy according to your needs and budget. Contact us to start your journey the right way!