By Jeff Rothstein I October 6, 2020
Medicare Advantage Plans (MAPD) are organized and administered on a County and Regional basis. Some of the larger carriers that provide Medicare supplement plans also provide Medicare Advantage plans including United Healthcare, Aetna, Cigna, Blue Cross Blue Shield, and Humana.
However, since plan offerings vary by county, a carrier may offer an MAPD in Broward county that is unavailable in Palm Beach County. There are also quite a few local regional carriers that offer plans in only a few areas. For example, in Palm Beach County alone, for 2020 there are 47 different plans available from over a dozen different companies.
Nationally, about one-third of all Medicare beneficiaries are enrolled in Medicare Advantage plans. When compared with the cost of a Medigap policy, many of them believe that the lower or $0 additional premiums make them a good deal. But keep in mind that you may have copays and coinsurance when you use healthcare services.
This means that in a year of high medical usage, you’ll spend more on your Medicare Advantage plan than in years where you have low medical usage.
CMS Rules state that Medicare Advantage plans must cover all the same services that are offered under Medicare Part A and B. The difference is that your cost-sharing is set by the plan instead of Original Medicare. There is no one coverage that Medicare considers to be better. The reason there are so many choices is so that you can find a plan that feels suitable for your personal needs and budget.
Yes. You must be enrolled both Medicare Part A and Part B to enroll in a Medicare Advantage plan. If you are enrolled in an MAPD plan and stop making your Part B payment, you will be automatically disenrolled from your MAPD plan.
All MAPD plan specifics including costs are determined by the plan carrier. Some MAPD plans have deductibles, but most in South Florida do not. The insurance carrier offering the plan decides what the deductibles and copays are. This is why you should compare plans, and be sure to review the Summary of Benefits in detail having a good understanding of exactly what costs you will be responsible for before enrolling in that plan.
Some plans may have no deductible for Part A or B but do have a deductible for Part D. The Part D deductible cannot be higher than Medicare’s standard guideline for that year. Some plans charge the full deductible while other plans require a partial deductible. Some plans may waive the deductible altogether. Remember that while every MAPD plan must include at least what original Medicare includes, all plans are different.
In South Florida, many, if not most MAPD plans have no additional premiums beyond your Part B monthly premium. Most MAPD plan costs are through copays for services.
If you are turning 65 and plan to enroll in an MAPD plan, you can do so in your Initial Enrollment Period (IEP). You will have three months before your birthday, your birthday month, and three months after to select your plan.
If you are considering a change in plans in 2021, the Annual Election Period (AEP) is the best time to change. This period runs from October 15th through December 7th each fall. Plan changes take effect January 1 of the following year.
If you decide to leave your Medicare Advantage plan and return to Original Medicare, you must notify your Medicare Advantage plan carrier or Medicare will continue to show that you are enrolled. This can create a billing nightmare. We see it often among people who enrolled on their own without the help of an agent.
It is always best to enroll in Medicare Advantage through an insurance agency like South Florida Health Options. Jeff Rothstein will fully explain how Medicare and the plan you choose the plan works. Enrolling without an agent means you are on your own if problems occur on the back end of your policy.
Although every situation is different. Jeff Rothstein and South Florida Health Options provides unbiased information to help you decide. Our service is free.
Contact Jeff Rothstein at South Florida Health Options today at (954) 270-9114. We work with most carriers in South Florida including United Healthcare, Humana, Aetna, Simply, WellCare, and many others. Let us become your Medicare and Senior Benefit Advocate.