Should You Consider a Switch to Medicare Advantage?

Most of us over 65 are familiar with Parts A and B of Medicare, but how much do you know about Medicare C, also called Medicare Advantage?

Medicare C plans are regulated by the government and run by private insurers. They offer coverage comparable to Medicare A (hospitalization) and B (doctors’ bills, medical tests and some screening procedures) and may include prescription drug coverage.

There are a number of Medicare C plans available, with differing premiums, copays and out-of-pocket limits. Some cost about the same as standard Medicare, while other plans have higher premiums.

But does a Medicare C plan make sense for you? It depends on your individual circumstances.
Here are some factors you may want to consider:

  • If you have standard Medicare, you don’t have a cap on out-of-pocket expenses. If these are mounting up, Medicare Advantage plans have a maximum cap of $6,700 a year, and many are much lower.
  • If your prescription costs are high but you don’t want to pay extra for the optional prescription coverage under standard Medicare, most Medicare C plans include this coverage. But consider this carefully: You may not be able to justify a higher-premium C plan just to obtain drug coverage.
  • Nursing home care and dental and vision care (not covered by standard Medicare) are covered by some Medicare C plans.
  • You have a better selection of providers with standard Medicare; Medicare C is not as widely accepted.