What to Consider When Researching a Medicare Advantage Plan

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Whether you are about to turn 65 or you are helping your parents navigate the Medicare process, it is definitely a good idea to do as much reading and research as you can.

But because there is a ton of info out there, it can be easy to feel bogged down when learning the alphabet soup that is Medicare and its Parts A, B, C and D.

For instance, if you are pretty sure that you want to apply for a Medicare Advantage Plan, or your parents feel that this is the best option for them, it’s important to know what to consider.

Please consider the following words of advice:

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Learn About Costs from Reliable Sources

You might have mentioned to a dear friend that you are unsure if you or your parents can really afford a Medicare Advantage Plan, only to get an earful of opinions and advice in return. While your friend is probably well-meaning, it is best to rely on reliable and reputable sources for such an important topic and consideration like finances. For instance, the Medicare.gov site is full of great information about all things Medicare. According to the site, out-of-pocket costs for a Medicare Advantage Plan (also known as Part C) will depend on a number of things. For example, whether it charges a monthly premium—some plans have none—if it pays any of the monthly Medicare Part B premium and/or if it has a yearly deductible, and if you or your parents will pay every time they go to the doctor. How much you pay for this plan will also depend on the type of health car services you need, how often you go to the doctor, and if you also have Medicaid. In general, Medicare will pay a fixed amount for your care every month to the companies that offer Medicare Advantage Plans—beyond that, each plan can charge different amounts and have different rules on how to use them.

Read about What Medicare Advantage Plans Will Cover

Again, because Medicare uses several letters to designate different plans and it is such an involved topic, it can be easy to be unsure what a Medicare Advantage plan will and will not cover. As the U.S. Department of Health and Human Services notes, this type of plan will cover all of Medicare Part A, which is the hospital insurance portion, as well as Medicare Part B, which is the medical insurance coverage. At this point, you might be wondering about things like dental care, vision coverage and prescription medications—and these are great questions to ask. Prescription medication is covered under the Part D portion of Medicare—an easy mnemonic device to remember this is that D is the first letter of the word “drugs”—and it is often bundled into Medicare Advantage plans. Since dental care and vision coverage are not covered by Medicare, they could both be key additions that are part of the Medicare Advantage Plan you select.

PPO and HMO: Decide Which is Best

Another key factor to consider when comparing Medicare Advantage plans is if you or your folks want to go with a PPO or HMO. In addition to having to decide if you want the plan to cover your dental cleanings and vision checkups, you also have to choose a PPO or HMO plan. Depending on which one you go with, you will have different options for the types of physicians you will be able to see, as well as how much you pay. Anthem, a Medicare-approved insurer, provides the different choices side by side, so you can more easily weigh the PPO/HMO options when comparing Medicare Advantage Plans. People with larger budgets may go for the flexibility of a PPO, which gives you a wider selection of doctors you can see; but if money is especially tight—especially after adding in desired things like dental care—an HMO may be the best bet.

Knowledge is Power

Yes, researching Medicare Advantage Plans may seem like a huge chore and yes, you are bound to get all sorts of opinions from people you know. But by sticking with reliable online sources like the ones mentioned above, and knowing you have to keep certain topics in mind, it will be easier to learn what you need to know and make the best decision for you.


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