Monthly Archives: May 2011

“I’m afraid of Medicare Advantage plans. I hear the government is going to eliminate them and then what will I do?”

I hear that often–and it’s a legitimate concern. Medicare Advantage plans are mysterious and unknown to most people, and what they’ve heard from the Obama Administration is the plans are not good for seniors and should be eliminated.


So what’s the truth about Advantage plans and should they be considered a safe Medicare insurance option?

First, a little background. Medicare Advantage plans, sometimes called Medicare part C, originated with the Balanced Budget Act of 1997. The Act allowed Medicare recipients to opt for medical coverage from a private insurance company rather than the federal government. In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which allowed the addition of prescription drug coverage. Once drugs were included in the plans, Medicare Advantage took off. Today more than 11 million people have Medicare Advantage plans and an increasing number of people have enrolled each year.

Why have millions of people signed up? They have the convenience of having one insurance plan that covers both medical and prescription needs. Plus, they pay low premiums when compared to Medicare Supplements. In fact, some Medicare Advantage plans have a $0 monthly premium.


Most people, when they hear ‘$0 premium’ ask, “What’s the catch?” The answer: There isn’t one. Medicare Advantage plans work because the federal government pays an insurance company to insure the Medicare recipient. However, therein lies a problem: the current administration is not a fan of paying insurance companies.


With original Medicare, the government insures Medicare recipients. The Obama administration believes it would be less expensive for the government to continue insuring Medicare recipients than to pay an insurance company to do it. So, with the Healthcare Reform Act, Medicare will begin gradually reducing what it pays to the insurance companies. The government’s intent is to increase the cost of Medicare Advantage plans to the recipients so Advantage Plans no longer have a cost advantage over original Medicare


Will the new Congress rescue Medicare Advantage plans? Maybe. Some Congressional Representatives have been working to make sure Medicare Advantage remains available in its current form. But with the pressure to reduce federal spending, it’s uncertain how effective their efforts will be.


So, back to our question, “Are Medicare Advantage plans a safe insurance option?” My current answer is yes. Although insurance companies have not yet released details of their 2012 plans, United Healthcare has already announced they will offer a $0 premium plan for next year without significantly reducing benefits. That’s good news. It indicates United Healthcare feels it can be very competitive in the marketplace and still make a profit. Other companies seem upbeat as well.


Medicare Advantage plans have offered consumers excellent health insurance in the past at a very affordable price. It appears it will again next year; and I expect 2012 will see enrollment in these plans continue to grow.


Will my answer be ‘yes’ next year? I believe so. I think Medicare Advantage plans will be here in the foreseeable future. I believe companies will continue to put together plans that will have advantages over original Medicare.


But let’s say I’m wrong and you are on a Medicare Advantage plan that decides to exit the market. You are guaranteed the ability to go back to original Medicare and obtain a Medicare Supplement without health questions. That sounds pretty darn safe to me.

If you’ve not tried a Medicare Advantage plan before, you can have a 12-month trial period to see if you like the plan. If not, you can go back to original Medicare and a Medicare Supplement, again, without having to answer health questions.



Keep in mind every individual is different. What is an ideal plan for your neighbor is not necessarily the best plan for you. If you have questions about Medicare Advantage plans, Medicare Supplements, and Medicare Part D prescription plans, give us a call at 260-496-9229. We’re here to help you find the best plan for you by making Medicare easy.