Minnesota Medicare Advantage Plans Explained
The advantages of Medicare Advantage (MA) plans are found in what they can cover that Original Medicare cannot. Specifically, the MA plans available in Minnesota can include minor healthcare benefits such as prescriptions, vision, hearing, dental, fitness, telehealth, and more. In contrast, Original Medicare only covers major medical healthcare services.
Many people love the extra benefits they get with their MA plan. However, before you jump in with both feet, take the time to fully understand the trade-offs. The extra benefits and perks are nice, but they come at a cost. Specifically, when you join a Medicare Advantage plan in Minnesota you are agreeing to accept the plan's managed care health system. As an MA plan member, you agree to let the plan be a gatekeeper and fully control your access to doctors and other healthcare providers.
Medicare vs. Medicare Advantage: What's the Difference?
The big differences between traditional Medicare coverage and what you get with Medicare Advantage are easy to see by pointing out the pros and cons. Neither type of insurance is perfect. They each suit different needs.
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 Supplements vs. Medicare Advantage
We're frequently asked:
- 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 just a minute to dispel any misconception that these plans are bad or might have serious disadvantages.
Why Minnesota Medicare Advantage Plans are Bad
First things first. Medicare Advantage plans are not bad. More than 20% of all Medicare beneficiaries in Minnesota have a Medicare Advantage plan. But, it's not for everyone.
In particular, if you have one or more chronic conditions, Original Medicare could be a better option because you have the ability to choose your doctors. MedicareWire believes that Medicare Advantage is the best option for healthy people and for people who qualify for both Medicare and Medicaid.
Conversely, Original Medicare and a Medicare supplement work best for people with chronic health conditions (based on overall cost), as well as those who can afford a higher monthly premium, even when they are well.
Are There Disadvantages to Joining a Medicare Advantage Plan in Minnesota?
As you have already read, both Medicare Advantage and traditional Medicare have their benefits. But the two types of coverage are like apples and oranges. However, if you remove the issue of doctor choice from the equation, the primary difference is when and how you pay.
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 Minnesota, 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 Minnesota Medicare Advantage Plans
Minnesota Medicare Advantage plans are not statewide, they are local. So, the only way to answer this question is to enter your zipcode here.
Most Medicare Advantage plans available in Minnesota include a Part D plan, but not all. Before joining a plan, be sure to check that all of your most important medications are covered. You can do that with this tool.
While not for everyone, Medicare Advantage plans have their benefits. The best way to understand these plans is to evaluate your health and financial situation. Here is an article that will help you make the right choice.