4 Myths About Medicare Advantage: Debunking the Misconceptions

Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) plans have become increasingly popular in recent years, with more and more Medicare beneficiaries opting for these plans over traditional Medicare. However, there are still many myths and misconceptions about MA plans that may be preventing some people from considering this option.

Myth #1: Medicare Advantage plans are more expensive than traditional Medicare.

Fact: Medicare Advantage plans can be more affordable than traditional Medicare, especially for people who require frequent medical care. Many MA plans have low monthly premiums, and they often include prescription drug coverage and other benefits not covered by traditional Medicare. Additionally, MA plans typically have out-of-pocket maximums that limit the amount beneficiaries must spend on healthcare each year.

Myth #2: Medicare Advantage plans have narrow networks.

Fact: The truth is that MA/MAPD plans can have very broad networks. Plans can be customized and offer the flexibility to utilize a passive PPO network. In a passive PPO network, individuals can see any provider who participates in Medicare and accepts Medicare payments.

Myth #3: Medicare Advantage plans are difficult to navigate and understand.

Fact: While navigating healthcare can be challenging, Medicare Advantage plans provide an Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents to all enrollees each year, outlining the plan’s benefits, costs, and rules. Beneficiaries can also seek assistance from their health plan carrier’s member service, Medicare counselors, brokers, reputable online resources, or the toll-free 1-800-MEDICARE number. Federally funded State Health Insurance Assistance Programs are available to provide additional support through trained volunteers and staff members.

Myth #4: Medicare Advantage plans are not as robust as traditional Medicare.

Fact: Medicare Advantage plans are required to cover all the same treatments as traditional Medicare. In fact, with group Medicare Advantage plans, we have seen enhanced benefits such as lower copays, access to 90-day supplies of medication through mail-order or retail pharmacies, and ancillary benefits such as dental, vision, and health and wellness programs. When plan members actively engage with these programs, their overall health can improve, potentially resulting in fewer doctors’ visits, hospital stays, and emergencies.

RetireeFirst is a trusted partner and Medicare expert, ready to assist group retirees in making their Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) plans easier to navigate. With our deep knowledge and understanding of the intricacies of these plans, we provide comprehensive guidance to help plan sponsors and retirees make informed decisions. Our personalized support, tailored solutions, and commitment to maximizing the benefits available make RetireeFirst the ideal resource for groups seeking to navigate MA/MAPD plans with confidence.

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