Your Insurance … with Michele Campbell: Which is better, Medicare with a supplemental plan or with an advantage plan?

Medicare Advantage plans can limit your freedom of choice of health care providers.

By Michele Campbell

Michele Campbell

Medicare Advantage, also known as Medicare Part C, makes it possible for people with Medicare Parts A & B to receive their Medicare benefits in an alternative way. Medicare Advantage plans are offered by private insurance companies contracted with Medicare and provide at least the same level of coverage that Medicare A & B provide. Let’s look at the pros and cons of choosing an Advantage plan.

Medicare Advantage (MA) Plans — The Pro Side

Medicare Advantage plans must offer at least the same coverage as Original Medicare Parts A & B and many plans offer added benefits. These benefits may include vision, dental, hearing coverage, gym membership, drug coverage, emergency assistance device and over the counter coverage.

These plans often have a lower monthly premium and have a maximum out of pocket cost. After you have met your maximum, you pay nothing for medical expenses for the rest of that calendar year. Original Medicare doesn’t provide a maximum out of pocket.

Cons of Medicare Advantage (MA) Plans

Medicare Advantage plans can limit your freedom of choice of health care providers. Typically they use networks of providers that you must stay within and if you choose to see a doctor outside the network, you possibly won’t be covered, or the cost for that provider will be very expensive.

MA plans have specific service areas, often regional by county, but sometimes by zip codes. You must live in the plan service area in order to enroll in that plan.

The providers are typically in these areas so if you live in two places, you would not be able to use a provider in your other location.

You would have emergency and urgent care coverage in all areas in the United States.