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Medicare Advantage Costs in 2021

How much your Medicare Advantage plan will cost you depends on a variety of factors. Which plan you choose, the insurance company that you purchase it through, whether you visit in-network or out-of-network providers, and even your ZIP code can all impact your costs for Medicare Advantage coverage.

Monthly Premiums

One upside of Medicare Advantage plans is their relatively low monthly costs. Medicare Advantage premiums tend to be quite reasonable, and according to the Kaiser Family Foundation, the average Part C monthly premium was only $25 in 2020.

Believe it or not, 60% of Medicare Advantage enrollees paid nothing for their Medicare Part C monthly premium in 2020.

Remember that most people covered under a Medicare Advantage plan are still responsible for covering their Medicare Part B premium. The cost of a Medicare Part B monthly premium is $148.50 for the majority of Medicare beneficiaries in 2021. 

Deductibles

Certain Medicare Advantage policies, such as MSA plans, have deductibles that you must meet before your coverage kicks in. If your plan has a deductible and a network, it is possible that only in-network care will count towards your deductible

Your plan’s coverage may not kick in until you have reached your deductible. Therefore, you should pay close attention to these amounts when deciding whether or not a plan is right for you. 

If you need guidance in choosing a Medicare Advantage plan, don’t hesitate to reach out to the team here at Medicare Plans Direct. We can compare Medicare Advantage plans from various insurance companies to ensure that you are getting the health insurance coverage that fits your needs. 

In-Network vs. Out-of-Network Providers

As we mentioned above, certain Medicare Advantage plans, such as HMO and PPO plans, have networks of medical providers from which you are authorized to receive care for covered services. If your plan has a deductible, out-of-network care may not count towards it. 

Plus, if your plan has a network and you choose to seek out-of-network care, you may be personally responsible for covering the cost of your coverage. You will almost always have to pay a higher price than you would if you were to seek treatment from an in-network physician.

Coinsurance/Copayments

Your Part C plan may also require you to pay coinsurance or copayments for your care. These rates can be different under your Medicare Advantage policy than the rates that are set by Original Medicare. We recommend you pay close attention to these potential expenses when enrolling in a plan. 

Coinsurance and copayments can apply to a number of medical services if you enroll in a Medicare Advantage plan. This can include visits to your primary care physician, visits to specialists, visits to the emergency room, and more.

Out-of-Pocket Limits

All Medicare Advantage plans have out-of-pocket limits. This helps to put a cap on what you will have to pay in medical expenses and is one big difference that sets Medicare Advantage plans apart from Original Medicare. 

Though out-of-pocket maximums vary from plan to plan, Medicare has set the 2021 in-network limit at $7,550 (and $11,300 for in- and out-of-network combined) for Medicare Advantage plans. This amount doesn’t include out-of-pocket expenses incurred from prescription drug purchases.

However, the amounts listed above are the maximum limits, so many Medicare Part C plans have even lower limits. These limits help to keep your out-of-pocket costs under control, which is especially helpful if you fall very ill or have to undergo an expensive treatment.

Prescription Drug Coverage

While some Part C plans include Part D prescription drug coverage, others do not. If you would like to have your prescription drugs covered, you should choose an Advantage plan that includes drug coverage. Alternatively, you may be able to enroll in a separate Medicare prescription drug plan, but only if your Medicare Advantage plan is a PFFS or MSA

However, signing up for a separate Medicare Part D drug plan is not permitted if you sign up for certain Medicare Advantage plans, like HMO and PPO plans.

If your Medicare Advantage plan doesn’t cover prescription medications and you don’t sign up for a separate drug plan, you will be responsible for covering 100% of your prescription drug expenses. Plus, in most cases, you will be subjected to a late enrollment penalty should you enroll in a drug plan after you first become eligible for Medicare (given that you didn’t have some other form of creditable drug coverage).

How can a Medicare Advantage plan help you to save money?

If you choose the right one for you, a Medicare Advantage plan may be able to help you to save money on your Medicare costs in the long run. 

Certain Medicare Advantage plans offer low or even $0 monthly premiums, and it is also possible to find a plan with a $0 deductible. Some plans even offer Part B Givebacks, bringing the cost of your Medicare Advantage coverage below $0! Plus, choosing a plan with a low out-of-pocket maximum can prevent you from having to pay exorbitant healthcare bills in the case of serious illness or injury. 

If you anticipate having high prescription medication costs, enrolling in a plan with drug coverage is another potential way to save money with your Medicare Advantage plan.

Choosing the right Medicare plan is no easy feat, as it involves researching plans to make sure your providers are in-network and your drugs are affordable. This can be a long process for an individual, but for us it is a quick and easy task.

Here at Medicare Plans Direct, we want to help you make a decision that gives you the coverage you need while saving you money. If you would like to speak with an experienced insurance agent about your Medicare Advantage options, get in touch today.

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