Medicare Advantage: Is There a Catch?

Medicare Advantage plans have proven repeatedly that they are the answer to many of the healthcare needs that arise with Medicare beneficiaries. This is one of the reasons why many Medicare beneficiaries are on the hunt for the best Medicare advantage plan and the top-rated Medicare advantage plans in 2021. But don’t take my word for it, a quick database research will show that on average 32,600 Medicare beneficiaries search the internet for the best Medicare advantage plan daily.

What is it?

Medicare Advantage plans, or Part C, are typically fully loaded with all the benefits of Part A and Part B. It is mandated by law. Medicare Advantage plans must offer the same benefits that Part A and B do or else they cannot operate under Medicare.

In addition to everything that Part A and B offer, Medicare Advantage programs are wildly known for offering additional benefits like dental insurance, vision insurance, hearing insurance, prescriptions, and transportation services at no additional cost. Most Medicare Advantage plans also come with an over-the-counter spending allowance to buy over-the-counter medicines and supplies. Some plans even offer you a reduction on the premium you pay for Part B monthly.

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Another important feature of Medicare Advantage plans is the MOOP – maximum out of pocket. This limits the amount of your medical cost you could be responsible for in a plan year. Why is this important? Medicare covers only 80% of the cost of your Part A and Part B benefits. This means that you are responsible for the other 20%. The problem is that the 20% has no end. It is infinite. There is no dollar limit on how much the 20% could be. For example, 20% could be $20,000 for a $100,000 hospital bill or $200,000 for a serious medical bill or series of medical bills that come with a price tag of $1,000,000.

No matter how many bills or how many services you need throughout the year, you must pay 20% each time. With the MOOP that comes with Medicare Advantage plans, you have a limit. For example, if the MOOP is $3,450, it does not matter how big your medical bill is or how often you need help. Once you already spent $3,450 for covered services, the plan covers you 100%.

Trusted Partners

So, these plans give me what Part B does and helps me pay for those benefits? Yes. So, what’s the catch? There is no catch.

One of the hardest things for most people to wrap their heads around is that a plan offers so much more benefits at no cost or a reduced cost. It does not make sense for a lot of people.

Well, let’s break it down…

Medicare Part A & B

Medicare Part A and Part B are provided through Medicare directly. By now, it is common knowledge that Medicare Advantage programs are offered through private insurance companies. These companies sign a contract with Medicare to provide all your healthcare through them.

So if your Senior Healthcare Advisors insurance agent chuckles on the phone when you ask them if Medicare Advantage is a scam, it is because Medicare Advantage plans are authorized by the federal government which proves that it is not a scam and that they are just trying to help you.

But why would these private companies take on such cost – especially in older people who are likely to use those services much more.

These companies don’t give you these benefits out of the goodness of their heart; they give you these benefits so they can be the best provider.

Payment Inquiries

Everyone pays a monthly premium for Medicare Part B. In 2021, that premium is $148.50 monthly. If you didn’t notice that you pay this premium, it is because you have Medicaid and the State that you live in pays the premium on your behalf. Another reason you would not pay a monthly Part B premium or pay significantly less is that you have a high level of Extra Help (Low Income Subsidy), or you are enrolled in an Advantage plan that offers a Part B reduction or Part B giveback.

Whether you pay your monthly Part B premium out of your pocket or someone pays it for you, that premium is passed on from Medicare to the private insurance company to maintain your benefits and coverage.

Therefore, Medicare Advantage plans are not magic plans with free benefits. They are also not from thin air. These plans are funded by Medicare who maintains those benefits using your monthly Part B premium.

Reasoning
Awareness
Perception
Memory
Attention

The good news is there are easy and simple ways to use your imagination to keep stimulating your mind and keep it sharp, including improving the quality of your life and health, the ability to keep connected, and feeling a sense of accomplishment.

Keep Our Seniors Connected

Something as easy as engaging in conversations with people daily can help you maintain your cognitive abilities. Furthermore, keeping a commitment to engaging in conversations will help you to stay connected with those you care about. Whether it is Facetiming or calling a friend, grandchild, child, etc., reminiscing about the wonderful memories you share, and taking the time to do it, will keep you mentally sharp.

Improves the Quality of Life

Using your imagination is a form of mental stimulation that can positively impact your overall health. The more active your mind is, the less of a chance you will have of developing physical problems, and mental health problems.

For older adults suffering from anxiety or depression, stimulating your mind and imagination with positive thoughts can reduce the symptoms and help you to feel joyful every day.

Stress can negatively impact your overall health and wellness, and combating stress with mental stimulation is a fantastic way that will increase your chances of living a happier and longer life.

Dreams are Forever

Do you picture lazy days on a hammock in the Bahamas? Maybe you have decided on a life of travel to all 424 National Parks in America. Or you will finally finish that science fiction novel you started months ago.

As the life expectancy for human beings has increased, people look at retirement as a “second life” rather than “the end of life”.

These days, people are turning to the dreams they’ve dreamt for many years rather than the familiar comfort of their chairs, as life is gearing up for another chapter.

The concept of retirement allows individuals to dream big. People may feel that they have fulfilled one career, they met their financial, social, and familial responsibilities and shed the chains of 9 to 5, finally free to do as they dream.

Strolling through a national park or hopping onboard a cruise are both valuable dreams you may want to look into. Here’s why:

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National Parks

National Parks are a fantastic way to embrace your golden years and explore all of the beauty and wonder the parks have to offer. Best of all, Senior Passes are available for access to the national parks and other federal recreation sites.

Cruises

Cruises are a great option for seniors to partake in. Trade in the maps and long drives for your pick of one of the dining options, pools, and entertainment available on a cruise.

Taking cruises is a perfect option for seniors to enjoy all of the amenities and new places luxury ships have to offer. Seniors can take an all-inclusive vacation with everything taken care of! Many cruise lines offer dance lessons, cooking demonstrations, fitness classes, bingo, and celebrity shows for all to enjoy.

What better way to bond with your family than on a cruise together? Let’s not forget to relax in the hot tubs, pools, and spas. Most ships cater to seniors offering the beauty of the sea and a way to visit many cities and places.

Here are some more reasons you may dream of the sea and why you should get on the ship to enjoy yourself onboard:

Port and explore many destinations all over the world
Watch a sunrise and sunset view along with the enormity of the deep blue sea surrounding you.
Stuff your face with all-you-can-eat dining
Go to the Movies
Partake in the Cruise’s casino activities
Enjoy room service
Take in the salt water and ocean breeze
No need for dragging luggage
No driving

As we become older it is simple to just let life lead us rather than us leading our lives. We can’t live our lives on ‘auto pilot’. It’s not just another day to follow the status quo or to let the status quo become our lifestyle. It’s time to realize whether or not we are allowing age to steer us away from following our dreams or setting new goals. “It’s time to kick off the autopilot and follow our dreams for setting new goals, going to new places, and enjoying every minute we have left on this beautiful planet!”

***Disclaimer: This is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any further questions or concerns you may have with your provider.***

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