Posted by Bill Sandweg on 07 November 2022.
It is only early November and I am already sick to death of the advertisements trying to get me to enroll in a Medicare Advantage plan and I still have a month go before the open enrollment period ends. Every celebrity in an advertisement these days tells me I need to get what I deserve. Grumpy Marge needs to be persuaded to call the number on the screen. These ad campaigns must be working as the number of Medicare eligible Americans enrolled in Medicare Advantage plans keeps increasing every year. As of 2022, almost half of the eligible Medicare beneficiaries are enrolled in a Medicare Advantage plan.
If you remember nothing else, remember that there is no free lunch and that the extra benefits you are being offered in an advantage plan are going to be offset by savings somewhere else so that the insurance company running the advantage plan can make its profit.
The puzzle image here is a good one for our purposes because Medicare can be very confusing, even for the sophisticated shopper trying to figure out what is the best coverage for her. There is an alphabet soup of Parts A, B, D, F, G and so on. What are they and what do they do? If I want to enroll in an advantage plan, what are the trade offs? What must I give up?
I recently received a link from a private company that brokers health insurance. Their web site explained all of the different types of Medicare coverages available in Arizona and provided some data for the largest companies offering Medicare Advantage plans here. They also provided links to other sites with helpful information. Here is the link I received. It is definitely worth a look.
On the subject of Medicare Advantage plans, the site for which I gave you the link says there are four main types offered in Arizona. The first and most common is the HMO model, in which, in return for extra benefits, you give up the right to choose any doctor who accepts Medicare. You must have a primary care physician (PCP) in the HMO network and cannot see a specialist without a referral from your PCP. If your PCP decides you can see a specialist, it will usually be someone in the HMO network.
Next are the Preferred Physician Networks. Under this model, the care you receive from a physician in the network will cost less than care from a doctor outside the network. There are other types of Medicare Advantage plans offered in Arizona as well.
As the site points out, the best Medicare Advantage plan for you depends on what is most important to you in terms of costs, availability of providers, and ease of access. Arizona had 122 Medicare Advantage plans for sale in 2022, however, not all of them are available in all parts of the state. When comparing plans, you should consider cost, availability of physicians and hospitals, deductibles, co-pays and coinsurance, coverage area, out-of-pocket costs, and benefits. It can be quite a daunting task but can have a big effect on your pocketbook and on your access to health care. Good luck.