Video: Pros and Cons of Medicare Advantage

Cons of Medicare Advantage

Let’s start with the cons.

Con: Provider networks.

Most U.S. healthcare providers accept Original Medicare. On the other hand, Medicare Advantage plans often require you to go to a smaller provider network of doctors and pharmacies to make full use of your benefits.

Con: Plans may change annually.

Medicare Advantage plans may change from year to year. Assess your options during the Medicare Annual Enrollment Period each fall.

Con: Costs may vary based on your plan.

Original Medicare charges the same premiums, deductibles, copays and coinsurance anywhere in the country. Medicare Advantage plans all set their own costs, so make sure you have the insurance that fits your budget.

Pros of Medicare Advantage

That brings us to the pros of Medicare Advantage.

Pro: Additional benefits.

Many choose Medicare Advantage plans to get benefits that Original Medicare doesn’t provide, including Medicare Part D prescription drug coverage.

Pro: Out-of-pocket max.

Unlike Original Medicare, Medicare Advantage plans set an out-of-pocket maximum. After you spend that amount on covered healthcare, your plan will pay all the costs for additional covered services through the end of the plan year.