Kansas Medicare Advantage Plans Explained
Traditional Medicare covers about 80% of all major medical costs. It does not cover minor medical for things like vision, hearing, dental, and prescriptions. The Medicare Advantage plans available in Kansas can include minor medical benefits, but are not required to. Most do include coverage for prescriptions.
While it is nice to have coverage for minor medical costs, it is critical that you understand exactly what you get when you join a Medicare Advantage plan in Kansas. In particular, you need to know that these plans have complete control over your access to doctors and other healthcare providers. If you've ever had a managed care plan (HMO, PPO, etc.) through an employer, then you already know what to expect.
Medicare Advantage vs. Medicare: Is There a Big Difference?
The best way to understand the differences between Medicare Advantage and traditional Medicare is to evaluate the pros and cons of each type of coverage.
Medicare Advantage vs. Medicare: The Pros and Cons
- Doctor Choice:
- Medicare Advantage: Must use healthcare providers within the plan's network.
- Original Medicare: Use any Medicare-approved provider you choose.
- Medicare Advantage: Each plan can charge what they want for copays and coinsurance, making it challenging to compare actual costs.
- Original Medicare: Coinsurance and deductibles are predictable and you can get a Medicare supplement to help pay these costs.
- Medicare Advantage: You're protected by the plan's annual maximum out-of-pocket (MOOP) limit. Once you reach this spending limit the plan pays all additional copays and coinsurance for the rest of the year.
- Original Medicare: No out-of-pocket limit.
- Medicare Advantage: Most plans come bundled with a Medicare Part D plan for prescription coverage.
- Original Medicare: You must buy a stand-alone Medicare Part D plan.
- Medicare Advantage: You're covered for travel emergencies within the USA but not for routine doctor visits outside of your home county.
- Original Medicare: You're covered anywhere you go in the USA and its territories.
Medicare Advantage vs. Medigap
Most Kansas seniors just getting their Medicare benefits want to know which type of plan is better. We commonly see these three questions:
- Why are Medicare Advantage plans bad?
- What are the disadvantages of Medicare Advantage plans?
- Is it better to have Medicare Advantage or Medigap?
Let's take a minute or two to compare and contrast, shall we?
Why Kansas Medicare Advantage Plans are Bad
This is a myth. There's nothing wrong with Medicare Advantage plans. In fact, over 20 percent of all Medicare beneficiaries in Kansas choose Medicare Advantage.
What you really need to know is that these plans are not for everyone. Some people are better served with traditional Medicare and a Medicare supplement. The question is, which option is best for you?
A good way to figure out which coverage is best for you is to look at your health and your finances. If you have one or more chronic conditions and you can afford a supplement, traditional Medicare is likely the best option because you have the ability to choose your doctors. Conversely, if you are super healthy, or you are unable to afford a Medicare supplement, then Medicare Advantage is a viable option.
Here's the fundamental truth. Medicare plus a Medigap plan works best for people with chronic health conditions. It's also the best coverage for people who can afford a higher monthly premium, even if they rarely see a doctor.
What are the Disadvantages of Kansas Medicare Advantage Plans?
We have already highlighted the issue of doctor choice in Medicare Advantage. If this is not an issue for you, then consider the financial differences.
Medicare Advantage plans have a monthly premium, but it's generally less than a Medicare supplement, and some plans even have a $0 premium. But, you also pay when you use health care. These are the copays.
With a Medicare supplement plan you pay most of your costs in advance with monthly premiums. Depending on the level of coverage you choose, the plan can cover all of your copays, coinsurance, and deductibles except the annual Part B deductible. This makes your monthly healthcare costs more predictable, particularly if or when you have serious health problems.
Which is Best in Kansas, Medicare Advantage or Medicare Supplement Insurance?
- If you can afford Medigap Plan F or G, then keep your Original Medicare and add one of these supplements.
- If you are a healthy senior and have good health in your family heritage, Medigap Plan N will let you save money by sharing some costs when you see your doctor.
- If you are a healthy senior but you cannot afford a Medigap Plan F, G, or N, Medicare Advantage is a good choice.
- If you are turning age 65, have one or more chronic health conditions that require frequent doctor visits, and you do not qualify for both Medicare and Medicaid (dual eligible), the most Medigap coverage you can afford is the best option.
- If you qualify for both Medicare and Medicaid, regardless of your health condition, Medicare Advantage is your best option.
- If you have special needs (i.e., a full-time nursing home resident, diabetes, etc.) and an appropriate Medicare Advantage Special Needs Plan (SNP) is available, this is your best option.
Frequently Asked Questions About Kansas Medicare Advantage Plans
Medicare Advantage plans vary from County to County in Kansas. This is due to the local nature of healthcare provider networks. If you enter your zipcode into this tool it will show you all of your plan options and 5-star ratings.
One of the best features of Kansas Medicare Advantage plans is the extra benefits, including prescription drug coverage. Most plans include Part D, but not all. You can quickly see with plans offer it in your area by entering your zip code in this tool.
Some people love Medicare Advantage while others hate it. The only way to determine if it will work for you is to compare your health and financial situation with the plans available in your area. In this article you will learn how to do just that.