June 9


What Medicare Advantage Plan Is The Most Popular?

The United States government provides Medicare health insurance to citizens who are 65 years and older and others who qualify before 65 due to their disabilities. Although Medicare provides substantial coverage, it will still leave beneficiaries with out-of-pocket costs without a cap. Due to these out-of-pocket costs, many seniors purchase a Medicare Advantage plan for cost-sharing help. But what is a Medicare Advantage plan? What Medicare Advantage plan is the most popular?

What is a Medicare Advantage plan?

Medicare Advantage plans are separate from Original Medicare. Private insurance companies sell Advantage plans, but you must have Medicare Parts A and B first to be eligible to purchase one of these plans. Once you enroll in an Advantage plan, you will receive your Medicare Part A and Part B benefits through the carrier. Many Advantage plans include a Part D drug plan, as well. Some Advantage plans include additional benefits, such as dental and vision, but they are not required.

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The insurance company sets your cost-sharing amounts for your healthcare services. For example, your plan might set a 20% coinsurance for all healthcare costs, or they might charge a $30 copay for doctor’s visits and a $60 copay for a specialist visit. You can find this information in the Medicare Advantage plan’s Summary of Benefits. Since private insurance carriers sell these plans, every plan’s benefits are different. To learn about the plans available in your area, contact Boomer Benefits – Medicare Advantage.

Which Medicare Advantage plan is the best?

There are four main Medicare Advantage plan programs: HMO, HMO-POS, PPO, and PFFS. Out of these four programs, HMO Medicare Advantage and PPO Medicare Advantage plans are the most popular among Medicare beneficiaries.

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HMO Medicare Advantage

A Health Maintenance Organization (HMO) Medicare Advantage plan is popular among the Advantage plans, mainly due to its low monthly premiums. Many HMO Advantage plans have premiums as low as $0. But there’s a catch! When you have a premium this low, you will typically have more out-of-pocket costs for the year if you visit the doctor often. Luckily, Advantage plans have a maximum out-of-pocket limit of $7,550 in 2022.

When you enroll in an HMO Advantage plan, you must use the plan’s network of doctors and pharmacies. The network is local, and you must choose a primary care physician within your network. You must seek a referral to see a specialist that must also be in your network. If you were to go out of network for your healthcare, you would pay the bill’s total cost. However, you can go out of network in the case of an emergency, and your HMO Advantage plan would cover you.

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PPO Medicare Advantage plan

Due to its flexibility, many seniors favor a Preferred Provider Organization (PPO) Advantage plan. PPO Advantage plans have a network of doctors and pharmacies, but you can go out of network and still have coverage from your plan. Unlike HMO plans, you don’t have to experience an emergency to go out of the network. But, you will pay more for out-of-network services than in-network services.

You don’t have to choose a primary care physician, and a referral is not necessary to see a specialist with a PPO plan. You will find that PPO Advantage plans typically have higher monthly premiums than HMO plans. Instead of a low premium, you have the freedom to see any doctor in the U.S. that accepts your specific PPO Advantage plan.

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Wrapping up

Consider an HMO Advantage plan if you are looking for a plan with low monthly premiums and are content with a local network. Look into a PPO Advantage plan if you like to travel often and you’re your insurance to travel with you! If you aren’t sure which plan is the right one for you, contact a reputable Medicare broker for help shopping the plans in your area and compare the pros and cons of each program.

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