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Common Myths and Misconceptions about Medicare Advantage

Medicare health insurance

Medicare Plans are among the trending words in the healthcare sector in the USA. Due to the increasing population, access to quality healthcare becomes difficult for anyone approaching the 60s or 70s. For them, Medicare is that investment that protects their health and medical needs in the future.

There are 2 types of Medicare – Ordinary and Advantage. Ordinary Medicare covers the basic Medicare needs and facilities, whereas Advantage Medicare has a combination of ordinary plus some additional benefits, which is an appealing option. There is a lot of information about these Medicare Advantage plans, but the myths and misconceptions also rise as the information rises.

To take an informed and firm decision, it’s crucial to debunk these common myths and misconceptions which increase the confusion among the beneficiaries. In this article, we will unravel the truth behind these myths and present a clear picture of its plans. 

Advantage Medicare is the same as the original Medicare

Many people still believe that the two are similar and there is no difference in the coverage and plans they provide. However, the truth is that Advantage Medicare is controlled and regulated by private companies that Medicare approves. They do provide the same coverage as the original, but also provide some additional coverage for hearing, vision, and dental issues.

They ensure travel and drug prescription coverage which saves a person from high out-of-network service costs. Check and compare the costs of Humana Medicare Advantage plans 2024 and select the plan that meets your requirements, medical condition, and financial condition.

You can enroll in Medicare as per your wish

Medicare slip
Medicare insurance slip

This is a common myth that has been speculated on in the market for years. But the truth is you have to meet up to specific qualifications and fulfill the eligibility criteria. Moreover, there are some enrollment periods in which a person can apply for the Advantage plan only.

Failure to do so can lead to legal and financial problems. Generally, people become eligible to apply for a medical advantage plan when they reach the age of 65 years. However, in rare cases of disabilities or extreme medical conditions, a person becomes eligible to apply earlier also. The minimum initial enrollment period is 7 months, which people have to fulfill before they cross the age of 65.

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Medicare Advantage plans are more costly

Many people think that these plans are more costly, but the truth is they cover all the needs in a single plan. Original Medicare has many copays, deductibles, premiums, maximum out-of-pocket, and other services that are not included in it. A supplement Medigap plan has to be purchased at an additional cost to get those benefits. Whereas it already includes these benefits that require additional money in the case of the original plan.

In a broader view, advantage plans are more cost-efficient, plus the cost depends on the types and amount of premiums, deductibles, network, location, health status, and copays. They have a yearly out-of-pocket limit which allows beneficiaries to take the coverage. After exceeding the limit, they don’t have to pay any amount for the remaining year. 

Medicare Advantage and Supplement plans are the same

Medicare advantages
Medicare advantages

Medicare Advantage and supplement plans like Medigap and MedSupp are two completely different plans that cannot co-exist together. This means a person cannot take both plans together as a supplement plan can only be taken along with the original plan to get the extra coverage and features that an Advantage plan already has.

They have a higher premium, and you have to purchase the drug prescription coverage via Plan D, which is already present in the Advantage plan. It’s always suggested to choose the Advantage plan rather than a combination of the original supplement and plan D, which ultimately costs you much more than the Advantage plan.

Moreover, even the combination of three plans does not provide unlimited emergency coverage abroad, which one Advantage plan does.

Advantage plans are only for healthy people

It’s a common misconception that the Advantage Medicare plan is only for healthy people, and it can drop you if you are sick or have an existing medical condition. But they cannot deny accepting the application or providing the coverage just because of your health status.

This even started provisioning coverage for chronic conditions. You just have to pay the premiums and satisfy their conditions and requirements to receive the coverage.

Healthcare plans cannot be changed 

Insurance plan
Insurance plan

It’s a common misbelief that once you get the Advantage plan, there is no way to change it. You or the person for whom you have taken the Advantage plan may not like it for some reason. You can easily drop or change it online or via phone on 1st January or between October to January.

15 October to 7 January is the time enrollment period, and the 1st of January embarks on the start of new coverage. So, it’s the best time to shift your plan and try something else. However, if you change to any other time in the year, you must wait until October to enroll in a new plan and get the new coverage. 

You automatically get enrolled in Advantage Medicare after reaching 65

A person automatically enrolls in the original plan if they receive social security. However, this is not true in the case of an Advantage Plan, supplement plan, or plan D. A person has to take specific steps to enroll in the Advantage Plan when reaching the age of 65 years.

Compare the advance plans’ coverage, cost, benefits, premium, etc., and choose the most suitable one. Apply to enroll in the plan when the application starts, i.e., on the 7th of October, and fulfill their criteria for a minimum initial enrollment period of 7 months.

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Medicare Advantage plans are the most successful and popular Medicare plans that provide all-in-one services in one single plan. We have debunked the common myths and misconceptions that confuse people about these valuable Medicare plans that ensure full coverage, long-term savings, health security, and a golden future. Being a 65-year-old citizen, it’s time to check and compare various plans and secure your health and future life.


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