Health ๐Ÿƒโ€โ™€๏ธ

Do You Know What Medicare Plan Is Perfect For You? Check These Facts To Help You Decide

There are so many things that we need to factor into our lives to maintain a certain quality of life. With the rising costs of medical treatments, itโ€™s not wise to cruise through life without thinking about what would happen if you were to fall terminally ill or even have an accident. A medicare plan is absolutely essential for anyone serious about their health and personal finances since it can help save you from bankruptcy in case of an unfortunate scenario.

blue and silver stetoscope

However, the biggest question on peopleโ€™s minds is what plan should they go for. There are two widely available plans; the Medicare Advantage plan and the Original Medicare plan. Choosing the right plan is very important and if you make the wrong choice, it can lead to significantly higher bills that you might have to pay for yourself.

Today, weโ€™re going to have a look at the different factors that determine if you should go with a Medicare Advantage plan or an Original Medicare. Once youโ€™re done reading this article, youโ€™ll have a much better idea of whatโ€™s best for you.

1. Coverage

This should be one of the most important factors you consider while choosing between the two plans. The Original Medicare will cover the cost of supplies and medical services in a  hospital, the doctorโ€™s clinic, and any other relevant settings. Whereas, a Medicare Advantage plan will cover all of those as well as some additional benefits like vision, hearing, or dental coverage.

2. Costs

The costs of a Medicare plan depend on a number of factors. The various costs covered by your Medicare plan usually include premiums, deductibles, hospital stays, visits to the doctor, and much more. You have to understand exactly what your plan covers and how it might affect your expenses. 

In the case of Original Medicare, there will be no limits to the amount of money you might have to spend out of your own pockets. Whereas, in the case of Medicare Advantage, there will be a certain limit to the yearly out-of-pocket costs you might have to incur. This offsets many of the disadvantages of a Medicare Advantage plan since youโ€™ll end up saving a lot more money in case of a serious illness.

3. Copays

The biggest problem that people face in understanding a medicare plan is perhaps the copay. In the case of Medicare Advantage, youโ€™ll have to pay money when you actually utilize the services of the Medicare plan, besides paying the monthly premiums. What this means is that youโ€™ll end up โ€œco-payingโ€ every step of the way. When you meet your doctor for consultation, when your doctor refers you to a specialist, and when the specialist asks you to get a lab test done, youโ€™ll have to pay some money.

Whereas in the case of an Original Medicare plan, youโ€™ll have to pay your annual and monthly premiums but when you actually utilize the services, you donโ€™t have to pay anything extra. This is the fundamental difference that should influence your choice of the Medicare plan.

4. Quality of Treatment

The biggest qualm that people often have with Medicare Advantage is that they think theyโ€™ll end up getting a lower quality of care when compared to Original Medicare. This is a major point of contention and it isnโ€™t completely false.

Usually, a Medicare Advantage plan will utilize a capitation mechanism to pay the healthcare providers for their services. This means that the insurance provider will pay a flat fee to the healthcare provider for each patient they see. 

What usually happens is that nurse practitioners are assigned to see the patients so that the costs are significantly lower than assigning an actual doctor. This concern might not be that big of a deal since these nurse practitioners often work under the supervision of a qualified physician too.

These are some of the most important differences between the Original Medicare plan and the Medicare Advantage plan which should help you figure out which one suits your needs better. This list tries to address the most common concerns and popular misconceptions in the minds of those who might not be aware of how Medicare works. However, it is not to be considered exhaustive and can cover a lot more details. If you decide to choose a Medicare plan then keeping these factors in mind can help you save a lot of money in the long run since it all depends on the kind of ailment you might be suffering from.

Krystal | Sunny Sweet Days
Follow Along
Latest posts by Krystal | Sunny Sweet Days (see all)

Similar Posts