How to Figure Out Your Medicare Advantage Costs

When choosing a Medicare Advantage plan, it can be challenging to figure out which plan will cost you less overall. With additional premiums, deductibles, coverage gaps and benefits at additional costs, figuring out the total expenses of plans can be a headache.

Here are some tips for how to break down the costs of Medicare Advantage plans before you sign up for a plan.

How to understand your Medicare Advantage costs ahead of time

Understanding your Medicare Advantage costs is best done by breaking down the different kinds of expenses associated with medical needs. These come in two parts: the fixed premiums that are paid on a monthly basis and the cost of medical care as it's needed.

The fixed cost: Your Medicare Part B Premium

No matter which way you use Medicare — Original Medicare, a Medicare Supplement Plan, or Medicare Advantage — almost every Medicare beneficiary needs to pay the Medicare Part B premium. $148 a month is the standard Part B premium in 2021 but that number can vary based on income and benefits.

You may see Medicare Advantage plans advertising $0 premiums. This simply refers to any additional premium on top of the Plan B premium, it does not mean you'll be able to avoid the regular Part B premium.

Other costs: Fees for services, additional premiums, and deductibles

These additional costs are key to comparing Medicare Advantage plans. However, it can take some work to figure out what these mean for your potential total expenses.

Additional premiums are the most straightforward cost to assess. Many Medicare Advantage plans have no additional premium, but they may have a small cost for optional benefits such as dental, vision or healthcare.

Your deductible is another vital cost to understand. Before your insurance kicks in any amount of coverage, you will need to meet your deductible. The deductible for Original Medicare is $203. Some Medicare Advantage plans have higher deductibles, while others have no deductibles.

The most complex part is figuring out how much you will pay for likely medical expenses. This depends on whether your doctors are in-network for a Medicare Advantage plan as well as what your copays and coinsurance will look like.

Original Medicare will cover 80% of the Medicare-approved amount for services. Many Medicare Advantage plans may cover more for in-network doctors but provide little or no coverage for out-of-network doctors.

Original Medicare also has no out-of-pocket maximum, meaning that there is no limit to what you could potentially spend on medical expenses in a year (although a Medicare supplement plan can help with this). Many Medicare Advantage plans have out-of-pocket maximums for both in-network and sometimes for out-of-network spending, making that the absolute most you would spend on medical expenses in a coverage year.

Luckily, there are some tools to help make these fluctuating expenses a bit more predictable. Using the Medicare.gov search tool for Medicare Advantage plans in your area, you can find their benefits, premiums, deductibles and maximums for comparison. You can even add any medications you take to easily compare the cost of different drug plans, as well as see limits for insurance coverage for different services.

Source: iQuanti, Inc.

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Categories: Healthcare Insurance

Tags: Healthcare, Healthcare Insurance, Medicare, Medicare Advantage