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Why Medicare Advantage Plans Are Bad

Why are Medicare Advantage plans bad
05/02/2022
  • Medicare with Melissa

Why Medicare Advantage Plans Are Bad…but, it’s not what you think.

It is our opinion that Medicare Advantage Plans are “bad” because they are mostly improperly explained by the sales representatives.

There are a lot of moving parts to these Plans and when not thoroughly reviewed and discussed with the beneficiary, the outcome could be devastating to the member.

Thus, in these instances, the member believes he/she is enrolling in a plan that may be suitable. However, the unfortunate reality, is that the plan is not suitable for reasons like, accepting physicians, referrals may be required, prescription coverage and more.

Regardless of the reasons, we are here to set the record straight and share a non-biased opinion.

Our agency represents over 25+ top rated insurance carriers with a wide variety of Medicare products to suit your needs. Whether you’re looking for a Humana HMO Gold Plus or United Health Care dual-complete plan, we have you covered and we are here to help you.

We strongly advise speaking to a professional Medicare agent prior to signing up for any Medicare plan. That way you can ensure you get the best plan for your individual needs and budget.

Need assistance choosing a Medicare Plan? We are here to help you every step of the way. Give us a call at 866-633-4427 to speak with a licensed agent today.

What is Medicare Advantage Insurance?

Medicare Advantage Plans are a type of health insurance you can choose when you are eligible for Medicare. You might also read or hear of these plans referred to as:

  • MA (Medicare Advantage)
  • MAPD (Medicare Advantage + Prescription Drugs)
  • Medicare Part C
  • Medicare Complete Plans
  • “All-In-One” Plans

… confusing, right?!

The most common types of Medicare Advantage plans are:

  • HMO (Health Maintenance Organization)
  • PPO Plans (Preferred Provider Organization)

These plans are similar in structure as the HMO and PPO plans available for people under 65 who are still working or plans available through the HealthCare Marketplace / Exchange.

Medicare Advantage coverage will “replace” Medicare and combine your Part A, Part B and in most cases Part D into one health plan (Medicare Part C).

The alternative to enrolling in a Medicare Advantage Plan is choosing a Medicare Supplement Plan (Medigap Plan).

Medicare Supplement Plans are not considered “all-in-one” health plans, because you need to add additional coverage to be fully covered, such as prescription coverage, dental, vision, hearing, etc.

What are the advantages and disadvantages of Medicare Advantage plans?

Advantages of Medicare Advantage Plans

  • Affordable premiums (in most cases, $0)
  • “All-In-One” health coverage
  • Can include extra benefits Medicare doesn’t cover
  • Special Needs Plans Available for those on Medicaid or with Chronic Health Conditions

Disadvantages of Medicare Advantage Plans

  • Network Restrictions (Service Area)
  • Some Plans Require Referrals
  • High maximum out-of-pocket to satisfy (when applicable)
  • Plan premiums, copays, network and overall benefits can change yearly

Medicare Advantage Open Enrollment

Other than you turning 65 or being newly eligible for Medicare, there are specific enrollment periods to obtain coverage.

Every year, there is an Annual Enrollment Period (October 15th-December 7th) which allows beneficiaries to change or enroll into a Medicare Advantage Plan.

Then, there is the Medicare Advantage Open Enrollment Period (January 1st-March 31st) which allows benefiaires to change their Medicare Advantage Plan or drop the coverage all together and go back to traditional Medicare.

Although these enrollment periods seem identical, the biggest difference in these enrollment periods that during the AEP you do not have to currently have a Medicare Advantage Plan to enroll or make changes. Whereas during the OEP, you must already have an Advantage Plan to make changes.

Disadvantages of Medigap Plans

Some of the disadvantages of Medigap Plans are:

  • Higher premiums than Medicare Advantage Plans
  • Premium Increases
  • Must add additional coverage to your Medigap Plan to help with the cost of prescriptions, dental, vision and hearing.

The most popular Medigap Plans are: Medigap Plan F, Medigap Plan G and Medigap Plan N.

Why are some Medicare Advantage Plans Free?

Yes, some Medicare Advantage Plans are “free”. These plans are also known as zero premium Medicare Advantage Plans. Not all Advantage plans are free, some have monthly premiums.

It is a true fact that some plans will cost you $0 monthly premium.

However, that does not mean that every time you go to the doctor or hospital its free. It simply means that you will pay nothing for your monthly premium on the plan. Other cost may be associated for rendered medical services, such as copays or coinsurance.

How can Medicare Advantage Plans be free?

Insurance carriers providing Medicare Advantage Plans are reimbursed by the federal government to maintain and pay for your healthcare. On average, the monthly reimbursement to the insurance carrier is estimated to be $900 per member per month (or $10,800 per year).

The government incentives and will pay more to plans that perform better and have a higher star rating. The highest rated plan is a 5 Star plan.

A 5-star rating is considered excellent. If a Medicare Advantage Plan with a 5-star rating is available in your area, you can use the 5-star Special Enrollment Period to switch from your current Medicare Plan to a Medicare Plan with a “5-star” quality rating.

These government incentives help carriers provide better benefits, such as, free or discounted gym memberships (Silver Sneakers), transportation, over-the -counter credits, Medicare flex card and Part B giveback, to name a few.

Pros and Cons of Medicare Advantage and Medigap Plans

We’ve put together two resources that can help explain the pros and cons of both types of plans.

Free Medicare benefits review

At Senior HealthCare Solutions, we provide a free Medicare benefits review for anyone who is eligible (under 65 or over 65).

Our services cost you $0, as we are compensated by the insurance carriers.

The plans, prices and benefits we provide are exactly the same as the insurance carrier. Our job is to Make Medicare Simple. Call us today for your free Medicare benefits review, 866-633-4427. You can also use our online schedule tool to book your appointment today!

Frequently Asked Questions

Can I have a Medicare Advantage and Medicare Supplement at the same time?

No, you can’t have both types of plans at the same time. In fact, it is illegal for an agent to knowingly sign you for both and could face serious discipline.

It’s important to never cancel your current coverage before new coverage is in place.

Related Article: I have a Medicare Supplement Plan, do I need a Medicare Advantage Plan?

What are the give back benefit zip codes?

Medicare give back zip codes, or Part B giveback benefits will vary by zip code. You can compare Medicare Advantage Plans with give back benefits using our online tool (no agent required).

Or, if you prefer, just call us at 866-633-4427 and one of our friendly licensed agents will ask some simple questions and provide a free Medicare benefits review.

We represent over 25+ top-rated Medicare insurance carriers and will let you know if you are eligible for the Medicare Advantage plans with give back benefits.

Does Humana offer any Medicare Advantage Special Needs Plans?

Yes! Humana offers several Special Needs Plans (SNPs – pronounced snips). These plans have limited membership.  They are designed to provide benefits to people with specific diseases, conditions, or limited income. These plans offer many extra benefits beyond Medicare. Special Needs Plans include:

(1) Dual Eligible: Medicare and Medicaid

(2) Chronic Conditions: Heart, Kidney, COPD

(3) Institutional

Give us a call at 866-633-4427 and talk to us plans available in your area. These plans often include Prescription drugs, dental, vision, hearing, over the counter benefits, in-home support benefits, gym memberships (Silver Sneakers) and more.   

Does Humana have a Medicare Advantage plan designed specifically for Veterans (vets)?

Yes, the Humana Honor Medicare Advantage Plan is designed with Vets in mind! Humana’s Honor Plan could provide you with options beyond your VA healthcare.

The bottom line is that enrolling in both the VA and Medicare plans will give you the flexibility in your options to choose your doctors, hospitals, and facilities where you receive your healthcare services.

Give us a call at 866-633-4427 and talk to us about how you can get Medicare benefits at no cost to you. There are $0 premium Medicare Advantage Plans specifically with vets in mind. These plans often include Prescription drugs, dental, vision, hearing, over the counter benefits, in-home support benefits and gym memberships (Silver Sneakers).

Is Humana Medicare Advantage a good plan?

Yes, Humana, as with other carriers offers some great Medicare Advantage Plans.

Humana Medicare Advantage plans with dental are always popular, as beneficiaries like all the benefits wrapped into 1 plan.

The Humana Gold Plus HMO seems to be the MVP of their Medicare Advantage plan portfolio.

Remember, when it comes to Medicare Advantage Plans, there isn’t a plan made for everyone.

Choosing the right Medicare Advantage Plan is critical, as your opportunity to change plans is limited. Medicare Advantage Plans are annual, contractual terms.

There are some special circumstances where you may be able to change plans in the middle of the year. Call us at 866-633-4427 and we will be happy to explain them to you.

Whereas the Humana Medicare Supplement Plans (like the Humana Plan F, Humana Plan G or Humana Plan N) allows you to change in the middle of the year.

Also, just because your friend, family or neighbor has XYZ Plan, does not mean it’s the plan best for you too.

How much is a Humana Medicare Advantage Plan?

That just depends on where you live and the plan availability. In general, Humana offers $0 premium Medicare Advantage Plans across most part of the country.

Compare Humana Medicare Advantage Plans online or call us at 866-633-4427.

Humana Medicare Advantage Reviews

Everyone has and is entitled to their opinion. When it comes to our Humana Medicare Advantage Review, we say go for it!

There are so many options when choosing a Medicare Plan, literally, thousands.

Some may come and some may go, and some never leave us. Humana is a company that has been around for decades, and the customer service experience is one of the best in the industry.

We always discuss the member experience with our clients, its important to know what to expect as a member of the plan.

With that said, Humana may not always have the most suitable plan in your area. That doesn’t mean they are a bad company- it just means we must look at other options that have suitable benefits and cost (and there are plenty of other good plans outside of Humana).

Why do doctors not like Medicare Advantage Plans?

The reason why some doctors may not like certain Medicare Advantage Plans (or insurance carriers), is because they say some of the companies pay slower than Original Medicare (and in some cases, less).

If you find yourself in a position that your physician does not accept your insurance, you will be left to decide between finding a new plan that your current physician accepts. Or find a new physician.

Does Humana Replace Medicare?

Depends. If you have a Humana Medicare Advantage Plan, then yes, technically the Humana Medicare Advantage Plans “replaces” traditional Medicare. In this case, Humana pays for services and then you pay the remining balance (or set copay amount).

On the other hand, if you have a Humana Medigap Plan, like a Humana Plan F, Humana Plan G or Humana Plan N, then you “keep” traditional Medicare.

In this case, Medicare is the primary payor, then the Humana Medicare Supplement pays second, and the remaining balance is paid by the member.

In either of these situations, you always keep your Medicare (you must have Part A and Part B to enroll in either of these plans).

In this example, we are using Humana. It would be the same with any insurance carrier offering Medicare Advantage or Medicare Supplement Plans.

Other popular Medicare Advantage insurance carriers are:

  • Aetna Medicare Plans
  • Allwell Medicare Plans
  • Bravo Medicare Plans
  • CareOne
  • CareOne Plus
  • Centene Medicare Plans
  • Cigna Medicare Plans
  • Florida Blue Medicare Plans
  • Freedom Medicare Plans
  • Kaiser Permanente Medicare Plans
  • Optimum Medicare Plans
  • Simply Health Medicare Plans
  • United Health Care Medicare Plans
  • WellCare Medicare Plans
Free Medicare Advantage Plans

Looking for Free Medicare Advantage Plans? Look no further! We have over 25 top-rated insurance carriers and you can look at Free Medicare Advantage plans online, without an agent.

Remember, our licensed agents are trained to compare all the plans available to you, just call 866-633-4427 or schedule your appointment now!

Is $0 coinsurance good or bad?

Having $0 coinsurance is definitely a good thing. This means your responsibility for this given service will cost you nothing, zero, zilch, notta.

Is the Medicare coverage helpline legitimate?

Yes, the Medicare coverage helpline is legit, but proceed with caution. Remember, the Medicare coverage help line is a 3rd party, private company that is well known for the Joe Namath commercial. Heavy advertising doesn’t always equal the best customer service or member experience.

Medicare Coverage Helpline Reviews

There are plenty of Medicare coverage helpline reviews you will find online. While this company is legit, they may not be a good fit for you.

You have options when choosing who you want your agent to be. Just like not all insurance companies are created equal, the same goes for insurance agencies providing you the service for your Medicare health insurance.

Get Your Free Medicare Benefits Review Today

Before enrolling in a Medicare Plan, its best to speak with a licensed agent to confirm plan benefits and assist with enrollment.

You can compare Medicare Benefits online now. Or call us today at 866-633-4427 and have one of our licensed agents to the digging for you. Feel free to schedule an appointment at a time that works best for you and the household.

Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.

-Melissa

Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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