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Medicare Advantage

Medicare Advantage Plans - we serve Illinois, Wisconsin, & Indiana

Medicare Advantage plans with Prescription Drug (MAPD) cover your medical costs as well as your Medicare Part D prescription drug coverage. Remember, these are Medicare Part C plans. These are combo plans—they cover the medical benefits of Original Medicare Parts A and B, as well as D. Approximately 45% of the sixty-seven million people on Medicare use this option. At a glance, it’s easy to see why. Premiums for these range from $0 to over $100, but most people pay $0 to about $40 per month for these. It’s a pretty compelling package to consider—you get Medicare Parts A, B, and D all in one package for a relatively low (or no) premium, hence its popularity.

These plans look sort of like traditional insurance you get from work, except, in most cases, they are far better. There are low copays for doctor visits, deductibles, coinsurance, and all of them must have a MOOP (eliminating Original Medicare Frustrating Flaw #1). Oftentimes, they do not have a deductible or coinsurances for many services. When they do, it’s usually for using doctors who are not in their provider network, or for certain categories of prescription drugs.

Many Medicare Advantage plans offer additional benefits that Original Medicare does not. Examples of this are dental, vision, and hearing coverage, post-discharge meals, and gym memberships. You cannot buy a federal or public-option Medicare Advantage plan. Medicare Advantage comes in a few shapes and sizes, but the vast majority of them are technically called Medicare Advantage-Prescription Drug plans. This acronym is pronounced M-A-P-D. There are MA-only plans out there, but those aren’t the ones we’re talking about here. Those are generally for veterans and folks on TRICARE.

When you buy one of these, it means you don’t flash your red, white, and blue Original Medicare card when you go to the doctor’s office—you put it in your top drawer. Do not throw it away, but it won’t work anymore. You get one card from the insurance company to use at the medical provider’s office, the hospital, and at the pharmacy.

In order to buy a Medicare Advantage plan, you must have Original Medicare Parts A and B. You cannot simultaneously have a Medicare Supplement and a Medicare Advantage, nor can you simultaneously have a stand-alone Medicare Part D Prescription Drug Plan and an MAPD plan.

That’s because an MAPD plan is an all-in-one combo plan. If you enroll in a stand-alone Medicare Part D Prescription Drug Plan while you already have an MAPD plan, you’ll get kicked off the MAPD plan. At the same time, if you already have a Medicare Part D Prescription Drug Plan and sign up for an MAPD plan, you’ll automatically get kicked off the Part D plan. Tread carefully and can guide you through this.

Using Medicare Advantage plans to cover your prescription drug and medical costs isn’t a set-it-and-forget-it way to consume your Medicare. It’s tricky and complex to buy, the premiums and benefits can (and do!) change every year, and insurance companies make you use their HMO or PPO networks. If you go this route, there are certainly benefits to doing so, and a third of the entire Medicare population can’t all be wrong—you’ll have to do some Medicare Housekeeping every year to make sure the plan you have this year is the best plan for you next year.

Related Services: Medicare Dental Plans, Medicare Supplement, Medicare Agents Near Me, Prescription Drug Plans, Medicare Part A, Medicare Part B, Medicare Broker

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