Choosing a Medicare Advantage Plan

Medicare Advantage plans combine Medicare Part A, Part B and usually Part D prescription drug coverage in one convenient bundle. That's why we use a solid triangle to represent them. They work the most like the health insurance you had before Medicare. You only need one ID card for all services. Your insurance company handles your claims.

With a Medicare Advantage plan, you'll get more benefits than Original Medicare. How many more benefits you'd like is just one of the decisions you'll need to make when choosing a Medicare Advantage plan. No doubt you'll also be concerned about what your plan will cost. That has a lot to do with how often you expect to use your health care. Thinking about this will help you find the right Medicare Advantage plan. Which category are you?

Grace is healthy and proactive about staying that way. She's rarely ill or needs medication. She makes sure she gets an annual checkup and necessary tests. On weekends she likes to go mountain biking. Her retirement income is modest, but she feels secure about what she has saved.

Grace may want to consider a Medicare Advantage plan with a lower monthly payment. Her health coverage use is light and she's budget-conscious. She can also get a plan with preventive benefits Original Medicare doesn't cover, like dental and vision exams

Plans with low monthly payments usually have higher out-of-pocket costs. So Grace will pay more when she does go to the doctor or pharmacy. If she breaks her leg while mountain biking, her medical expenses will likely exceed what she saved on monthly payments. But that may work for Grace, since she has savings to fall back on.

Alberto has high blood pressure. He's a self-employed accountant. Because he's still working and travels for business, he’s worried about health problems down the road. He sees his doctor for regular checkups and takes a prescription to manage his blood pressure.

Alberto's health coverage use is moderate now. He's also thinking about what he might need in the near future. A Medicare Advantage plan that balances cost and coverage would be a good fit for Alberto. He'd pay more each month for this plan. But what he pays for office visits and prescription refills would be lower. He can worry less about medical expenses if his high blood pressure does start to cause problems. He can also get a Medicare Advantage plan that provides coverage for doctor visits while he's traveling.

Miriam has been living with diabetes for the past 10 years. She sees her doctor often and purchases diabetic supplies regularly. Last year, she spent a week in the hospital because of complications from her diabetes.

Now that Miriam is turning 65, she's concerned. She'll have to pay 20 percent of the cost of her doctor visits and supplies if she only has Medicare Part A and B.

Miriam's a good candidate for a Medicare Advantage plan that has extended, or comprehensive coverage. Her monthly payments will cost more. But what she pays for office visits and prescriptions will be lower. It'll make her health care costs more predictable.