INSURANCE

Q: My husband and I are comparing a number of Medicare Advantage Plans. Which one is the best? Are Advantage plans better than Original Medicare?

A: There is no one ‘best’ Medicare Advantage plan. The best Medicare coverage for you – whether it’s traditional Medicare, a Medicare Advantage plan or a Medicare Supplement - will depend on your personal needs, including your overall health, the health care providers you prefer to use, your circumstances, the prescription medications you are taking and your budget.

Here are seven facts for you to consider as you compare coverage:

1. If you are in an Advantage plan, you will still be in the Medicare Program and have Medicare rights and protections. Advantage Plan members get complete Part A (Hospital Insurance) and Part B (Medical Insurance) coverage through their plan.

2. Many Medicare Advantage plans offer benefits not covered by Original Medicare, including routine vision care, hearing exams, dental care, prescription coverage, health club and gym memberships and more. Additional benefits vary between plans.

3. Most Medicare Advantage plans require you to use the plan’s network of doctors, hospitals, and other providers. If you go to a doctor, other health care provider, facility, or supplier who doesn’t belong to the plan’s network, your services may not be covered, or your costs may be higher.

4. You must follow plan rules, like getting a referral to see a specialist to avoid higher costs if

your Advantage plan requires it. The specialist you are referred to must also be in the plan’s network.

5. Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Each plan can have a different limit so check on this amount. Once you reach this limit, you’ll pay nothing for covered services. There is no out-of-pocket limit with Original Medicare.

6. Advantage plan enrollees continue paying their Original Medicare Part B premium. Monthly premiums for an Advantage plan will depend on the plan you select, with some plans available for zero monthly premiums.

7. You can join a Medicare Advantage Plan even if you have a pre-existing condition, except for End-Stage Renal Disease (ESRD)

I strongly recommend you talk to an insurance professional for help deciding which plan is best for you. As an agent and broker, I work with a number of insurance providers and can help you select the plan that will give you with the best coverage. Call me at 440-255-5700 or email Lmutsko@mutskoinsurance.com to set up an appointment, today. This year’s Open Enrollment period begins October 15 and ends December 7 for coverage beginning January 1.

Laura Mutsko Mutsko Insurance Services, LLC

6982 Spinach Drive, Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com

Laura Mutsko Agent, CSA and Certified Healthcare Reform Specialist