Decision time: Stick with Medicare Advantage or make a change

In the sea of healthcare options, finding the right plan can be a daunting task. And, as the clock ticks down with just one month left to make a Medicare change, the question on the minds of many Medicare recipients is, “Should I stick with Medicare Advantage or make a change?” 

It’s a pivotal decision that requires careful consideration of personal health needs, financial circumstances, and future expectations. Hopefully, you’ll find that this blog — and the people at Guided Medicare — can help provide some clarity. 

Understanding Medicare Advantage

Before we dive into the decision-making process, let’s briefly revisit what Medicare Advantage is. 

Often referred to as Part C, Medicare Advantage is an alternative to traditional Medicare. It bundles different types of coverage into a single plan:

  • Hospital Insurance (Part A)
  • Medical Insurance (Part B)
  • and — sometimes — prescription drug coverage (Part D) 

In addition to these basic coverages, many Medicare Advantage plans offer extra benefits like dental, vision, and wellness programs.

7 Things to Consider Before Deciding On Medicare Advantage

Here are seven things you’ll want to think about before making a decision about Medicare Advantage.

  1. How important is convenience? One of the primary advantages of sticking with Medicare Advantage is the convenience it offers. Everything from hospital visits to prescription refills can be streamlined into a single plan, reducing the complexity of managing multiple insurance components. 
  2. Have you weighed the costs? Consider potential savings with Medicare Advantage. These plans often have lower premiums, a plus for budget-conscious individuals. They also cap out-of-pocket expenses, creating a safety net lacking in original Medicare. However, weigh the financial aspect carefully. Original Medicare with a Medigap policy offers predictability in expenses, while Medicare Advantage may have upfront savings but could lead to higher out-of-pocket costs for certain services.
  3. How much flexibility do you need? Deciding whether to stay with Medicare Advantage or explore other options often boils down to individual needs. If flexibility is high on your priority list, it might be worth considering a return to traditional Medicare. Unlike Medicare Advantage plans, original Medicare doesn’t tie you to a specific network of healthcare providers. This is a crucial consideration for individuals who split their time between different locations or have specific healthcare professionals they wish to continue seeing. 
  4. Do you have enough for your medications? Coverage for your prescriptions is another aspect that demands scrutiny. While many Medicare Advantage plans include Part D coverage, it’s essential to evaluate whether your current plan aligns with your prescription needs. Formularies, which outline the drugs covered by the plan, can change annually. If your medications are no longer included or if the costs have skyrocketed, it might be a red flag to explore other options. 
  5. Do you feel more in control by having healthcare on your terms? For those who want some autonomy in healthcare decisions, original Medicare coupled with a Medigap policy might be a preferred route. Medigap plans, also known as Medicare Supplement Insurance, are designed to fill the coverage gaps in traditional Medicare. This combination allows you to choose your healthcare providers without the constraints of a network and provides the freedom to seek medical care anywhere in the country. 
  6. What about anticipating future health needs? Looking ahead is a big part of this decision-making process. If your health status has changed or you anticipate a shift in your medical needs, you’ll want to align your insurance plan accordingly. Medicare Advantage plans often have limited coverage for certain specialized treatments or out-of-network care. Figure out whether your current plan will cater to your future health expectations. 
  7. How important is consultation and collaboration? This is a trick question. It should be VERY important. — one of the most underutilized resources in the decision-making process is professional advice. Insurance agents and healthcare consultants can provide valuable insights tailored to your unique situation. Schedule consultations to discuss your concerns, understand the intricacies of different plans, and get a clearer picture of how each option aligns with your health goals and preferences.

It’s Medicare Advantage decision time!

As the decision time approaches, take a moment to think it through. Check what you need now and in the future, and weigh the good and bad of your Medicare Advantage plan. If it doesn’t quite fit anymore, don’t be afraid to look into other choices that suit your health and what you like. 

In healthcare, there’s no one right answer for everyone. Deciding to stick with Medicare Advantage or try something new is personal. It’s about balancing what you need now, what you expect in the future, and how much you want to spend.

The Medicare experts at Guided Solutions will help you find the perfect Medicare plan customized to your needs — and help you determine if sticking with Medicare Advantage — or returning to Original Medicare — makes sense for you. 

Request your complimentary consultation today, or if you’d rather chat with a broker in your area, locate an office nearby to set up an appointment.


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