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Betsy
Lv 7
Betsy asked in Business & FinanceInsurance · 8 years ago

Have you had positive or negative experience with a Medicare Advantage plan and which plan do you have?

My husband is going to be on Medicare. We are trying to figure out whether a Medicare Advantage plan is better or worse than regular Medicare. I would be interested in hearing about positive and negative experiences with either.

4 Answers

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  • Zarnev
    Lv 7
    8 years ago
    Favorite Answer

    It depends on the situation. Part of it is what plans and what types of plans are available in your area. There are several different types of Medicare Advantage plans. HMO, HMO/POS, PPO, PFFS, SNP, MSA, Dual, Cost and PACE plans are available. The plans are all a little different.

    Most of these plans have drug coverage, which is one benefit that can vary greatly. So much so that drug coverage is where I start in determining which plan to recommend to a client. The second place I look is doctor network. These plans have doctor restrictions; what those restrictions are depends on the type of plan and the location. Premium is usually a pro; some of these plans have a $0 premium in some locations.

    What someone else has doesn't matter. I have married couples that are on different plans with different companies. Also, these plans are county and even zip code specific so any suggestions you get here may not be available in your area.

    If you go with original Medicare you'll need to get a Medicare Supplement and a stand-alone Part D plan. Supplements come in different flavors as well, Plan A, B, C, D, F, hi Ded F, G, K, L, M, and N are available in nearly all states (3 states have different plans). Supplements generally will have a higher premium but lower costs if you use medical services. Part D plans can have deductibles but that is not always a bad thing. You'll need to do an analysis of his medications to find out what the cost will be with each plan.

    You'll need to compare the Supplements with the Advantage plans available before you can make an informed decision. Or, you can find an agent that works with all of the plans in your area. The agent can help him find the best plan for his situation and budget.

    Source(s): Independent Ägent Certified Senior Advisor®
  • Kini
    Lv 7
    8 years ago

    The Medicare and You book shows you the customer rating up to 5 stars for the Advantage plans. The Advantage plan works like a network or HMO or PPO. Original Medicare means you can see any doctor or specialist anywhere who accepts Medicare. The Advantage plans require you see only their network providers but it includes Part D. Original Medicare does not include Part D.

    The Advantage plans where I am cost $100 a month in addition to your Part B premium, but it includes the 20% of cost that Original Medicare doesnt cover so where I am, it is cheaper than buying a separate Medigap policy costing anywhere from $50 to $200 a month. All insurance plans vary in cost regionally.

    I have a Kaiser Advantage plan but Kaiser has its own hospitals so it is exceptional.

  • 8 years ago

    Zarnev is correct, but I have NO clients on a Medicare Advantage plan.

  • 8 years ago

    This varies wildly, depending on what state you're in and which plans are available in your state.

    Yes, lots of people have had both positive and negative experiences.

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