This guide answers the most common questions Utah residents ask when choosing a Medicare Advantage plan. Below you'll find every topic covered, with links to plain-English answers for each.
Peter Abilla is a licensed Medicare agent in Utah.No pressure, no cost — just clarity on your options.
Book a 20-Minute ReviewIf you’ve been watching television lately, chances are you’ve seen commercials for Medicare plans featuring famous athletes like Joe Namath. These ads can be eye-catching and leave you wondering what they’re actually selling and how it fits into your healthcare needs. Let’s break down these commercials to help you understand their message better.
The commercials typically promote private insurance plans that work alongside Original Medicare (Parts A and B). The most common types of plans advertised are Medicare Advantage plans (Part C) and Medicare Supplement Insurance, also known as Medigap policies. These plans aim to cover gaps in coverage or offer additional benefits beyond what Original Medicare provides.
Medicare Advantage plans replace your Original Medicare coverage with a plan offered by a private company. They can include extra benefits like vision, dental, or prescription drug coverage (Part D). On the other hand, Medigap policies are designed to fill in the cost gaps left by Original Medicare, such as copayments and deductibles.
Original Medicare covers hospital stays and medical services from doctors and hospitals that accept Medicare. However, it has some limitations and out-of-pocket costs like deductibles and coinsurance. That’s where Medicare Advantage plans and Medigap policies come in:
Medicare Advantage Plans: These plans cover everything that Original Medicare does, but they may also include extra benefits like prescription drugs, vision care, or dental services. You receive all your health coverage through a single plan from a private company.
Medigap Policies: These work alongside Original Medicare to help pay for some of the out-of-pocket costs that Original Medicare doesn't cover. Medigap policies do not include additional benefits like prescription drugs.
While these commercials often highlight attractive features, they don’t always tell you everything you need to know. Here are a few things to consider:
Networks and Providers: Some Medicare Advantage plans only cover services within their network of doctors and hospitals. If you go out-of-network, your costs may be higher or not covered at all.
Costs and Deductibles: The commercials might not mention that these plans can have different deductibles and copayments than Original Medicare. Make sure to read the fine print on how much you will pay for services.
Annual Changes: Plan benefits, premiums, and provider networks can change each year. What’s covered today may not be covered next year.
To make an informed decision, it’s important to compare different plans and understand what they offer. Here are some steps you can take:
1. Understand Your Needs: Consider your healthcare needs and any specific benefits that matter most to you, like prescription drug coverage or dental care.
2. Compare Costs: Look at the premiums, deductibles, copayments, and any other costs associated with each plan. Make sure you understand how much you will pay out-of-pocket for different services.
3. Check Provider Networks: If you have a preferred doctor or hospital, make sure they are in the network of the Medicare Advantage plan you’re considering.
4. Contact the Plan: Reach out to customer service representatives from the plans you’re interested in. They can provide more detailed information about benefits and costs.
5. Consult Independent Sources: The Medicare website (Medicare.gov) offers a comparison tool that allows you to look at different plans side by side. This can be very helpful when making your decision.
In conclusion, those TV commercials are just one piece of the puzzle. They’re designed to grab your attention and highlight certain benefits, but they don’t provide all the information you need to make an informed choice about your healthcare coverage.
Not affiliated with or endorsed by the federal Medicare program or any government agency.
Medicare Part B covers most outpatient cardiology services including EKGs, echocardiograms, and specialist consultations. Medicare Advantage plans cover the same services but with different copay structures.