Thinking of Switching to Medicare Advantage? 3 Things You Need to Know

The good thing about Medicare is that you get an opportunity every year to make changes to your coverage during fall open enrollment. That period began just a few days ago and is set to continue through Dec. 7. During open enrollment, you can switch Part D drug plans, switch Medicare Advantage plans, or move from original Medicare to Medicare Advantage.

If you’re contemplating doing the latter, you may be in good company. But before you make that switch, here are a few things you should know.

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1. You may have access to a wider range of benefits

Many seniors who sign up for original Medicare — meaning, Parts A and B plus a Part D drug plan — are shocked to discover that there are several common healthcare services the program won’t pay for. These include routine dental care, eye exams, and hearing aids.

One major upside to enrolling in a Medicare Advantage plan is that these services generally are covered. Not only do most Advantage plans pay for dental care, eye exams, and hearing aids, but they also offer a variety of supplemental benefits that can result in major savings.

Some Advantage plans, for example, cover the cost of a gym membership. Why do they pay for that service? It’s simple — to keep enrollees healthier so they can avoid costly medical issues. But all told, it could pay to look into the extra benefits Medicare Advantage plans provide and see if it’s worth moving over to one.

2. You may be limited to a more narrow network of providers

When you enroll in original Medicare, accessing care generally isn’t a big problem, because you could conceivably see a provider anywhere in the U.S. Medicare Advantage doesn’t work like that.

Rather, the care you’re entitled to under Medicare Advantage is similar to the care you may have received when you were enrolled in an employer health plan. Specifically, with Medicare Advantage, you’re generally limited to a particular network of providers, and going out of network could be expensive. Depending on where you live, switching to Medicare Advantage could mean giving up easier access to care.

3. Your costs may or may not go down

Although there are often exceptions, the general consensus on Medicare Advantage is that it’s a smart choice for people who are mostly healthy and don’t have many medical issues. But if you have a lot of health problems, you may find that you end up spending more on Medicare Advantage than original Medicare when you factor in the cost of copays and other expenses.

If you’re thinking of enrolling in Medicare Advantage, you’ll need to crunch the numbers and compare your costs to those you faced under original Medicare. Keep in mind that you can’t have supplemental insurance with Medicare Advantage to pick up the tab for things like coinsurance and deductibles.

What’s the right call?

Many seniors end up on a limited income that consists largely of Social Security benefits. If that’s the boat you’re in, you’ll want to stretch that income by keeping your Medicare costs as affordable as possible.

A Medicare Advantage plan could be your ticket to doing just that — but maybe not. So it’s important to understand the pros and cons of signing up for a Medicare Advantage plan before diving in.

At the same time, understand that all Medicare Advantage plans are unique. So if you’re convinced the time has come to move over to Medicare Advantage, review your plan options carefully before choosing one for 2023.

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