Medicare Advantage Plans in GA are privately run senior health insurance plans that replace traditional Medicare coverage. Most are either an HMO or PPO and require you to use a doctor or other medical provider that has agreed to the terms and pricing structure for the network.
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Medicare Advantage Plans = Fewer Choices
Medicare Advantage Plans have more restrictions and fewer provider choices than original Medicare and a Medigap plan.
- If you change to an Advantage Plan you may find that the doctor you have been seeing for years does not participate in your new plan and will only see you on a cash basis.
- Advantage Plans typically have low premiums, in some cases $0. The trade off is higher out of pocket when you need it most.
- Traditional Medicare and a comprehensive Medigap plan F supplement typically means you have $0 out of pocket for hospital and doctor bills when approved by Medicare.
- When you have a Medicare Advantage Plan, private insurance carriers, not Medicare, decide which claims will be paid and which will be denied.
- A large hospital bill that is approved by your Medicare Advantage carrier may leave you owing $3,000 or more once the dust settles.
- When you want to see a specialist you must first have a referral by your PCP (primary care physician) and that referral must be approved by your Advantage carrier.
- The rules for Medicare Advantage plans change every year
Medicare Advantage Pluses
To be fair, there are positive things about Medicare Advantage Plans.
- Advantage plans may include “extra” benefits such as limited vision or dental coverage
- Advantage plans require copay’s for doctor visits. Something you won’t find with most Medigap plans.
- Many Advantage plans include prescription drug benefits. Sometimes the “package” covers the medications you need, sometimes not.
- If you switch from original Medicare to an Advantage plan and you are not satisfied, you may disenroll during the first 12 months of your Special Enrollment Period (SEP) and return to original Medicare.
Types of Medicare Advantage Plans in GA
Most Advantage plans will fall in to one of the following categories.
- PPO
- HMO
- PFFS
- SNP
Why Seniors Leave Advantage Plans
We found this article titled, “As Seniors Get Sicker, They’re More Likely to Drop Medicare Advantage Plans“. Very interesting reading. However there is one issue NPR failed to address.
While it is true you can drop an Advantage plan during open enrollment and return to original Medicare, there is no guarantee you can qualify for a supplement plan.
Additional Reading
Differences in Original Medicare and Advantage Plans
Medicare vs Medicare Advantage – How to Choose
Choosing Between Traditional Medicare and an Advantage Plan
Bob Vineyard, President of Georgia Medicare Plans, has decided to specialize in GA Medigap plans. We believe the flexibility and overall VALUE of original Medicare and a supplement plan are superior to the Medicare Advantage plans currently on the market. We invite you to compare GA Medigap quotes using our instant online quote engine or ask for a free, no obligation consult.
