The Medicare system is funded by taxpayers. Employers and employees each pay 1.45% of the employee’s wages into the system. When individuals make more than $200,000, the employer pays an additional 0.9%.
If you’re over 65, you can get your Medicare benefits through the original Medicare plan or through a Medicare Advantage Plan which is comparable to an HMO or PPO. Most Medicare Advantage plans cover things that original Medicare does not like vision and dental.
You may have heard medicare advantage nightmares. Keep reading to learn some of the common complaints and disadvantages of Medicare Advantage plans before you decide on the right plan for you.
Why Medicare Advantage Plans Are Bad
You have to look at the details before choosing a Medicare Advantage plan because what may work for one person may not work for you and your individual situation as far as your health is considered. Let’s look at some of the downsides of Medicare Advantage.
- Unexpected Costs
Though you may pay a lower premium or no premium, you will have copays and payments for coinsurance which can add up. You’ll pay a copay to see your doctor. If you go to a specialist, you’ll have another copay. Tests or bloodwork will require another copay.
- Smaller Network
Most of these plans have a network of doctors and health providers in a smaller network that you’re required to use. Because these plans are local or regional, the number of providers is limited.
- Plans Change Randomly
You have to stay on top of the details of the plan. Changes can occur at any time. Most of the time the changes relate to your out-of-pocket costs like deductibles, premiums, and copays.
Why Are Some Medicare Advantage Plans Free?
Some of these plans are advertised as free because there’s no monthly premium when you enroll in the plan. The companies that offer Medicare Advantage plans with zero premiums contract with Medicare. Medicare gives them a certain amount of money to cover parts A and B insurance because as an employee, you paid into the system.
Part A is your hospital coverage: hospital services, home healthcare, nursing home care, and hospice. Part B is your medical coverage: preventive medicine, diagnosis, and treatment.
Advantage plans offer additional coverage beyond the basic Medicare coverage. You may have to pay more for out-of-network services.
Need Medicare Health or Prescription Drug Coverage? Check out MedicareWire for insurance plans for seniors.
Worst Medicare Advantage Plans
Now that you know the disadvantages of Medicare Advantage plans, you can make an informed decision and avoid medicare advantage horror stories. Be sure to read the fine print and get a list of the copays and deductibles. Verify that your doctor accepts the plan in which you are interested and that your meds are covered.
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