Medicare Advantage

There are a lot of Medicare Advantage plan options in my area. How do I decide which plan is best for me?

In choosing among the many Medicare Advantage plans, it is useful to think about what’s most important to you in a health plan. If you feel strongly about getting care from specific doctors and hospitals, it would be a good idea to review the provider directories of each Medicare Advantage plan to be sure the hospitals, doctors, and other health professionals that matter most to you are in the plan network.

If you are most concerned about premiums and other costs, you might begin by looking at monthly premiums, but keep in mind that premiums are not the only costs you will face. Enrollees can also incur costs when they use services, and plans can vary in how much they charge for doctor visits, hospital stays, and other medical services.

One specific feature to check is the out-of-pocket limit for Medicare-covered services. All Medicare Advantage plans include a limit of no more than $8,850 on out-of-pocket spending for in-network services and $13,300 for combined in-network and out-of-network services covered under Medicare Part A and B in 2024, but they vary in the amount of out-of-pocket protection they provide.

Also, keep in mind the cost of your medications as you compare plans. Most Medicare Advantage plans include prescription drug coverage. If medication costs are a key concern, you can compare Medicare Advantage plans in your area to estimate how much you would pay under each of the plans offered in your area. There is a searchable tool on the website that allows users to enter in the specific drugs they take, the dose level and frequency, along with preferred pharmacies, and provides estimates of total out-of-pocket spending on drugs under each plan.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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