How to Bulletproof your Medicare Advantage Plan

Written by: Dave Majher | Last updated January 1, 2022

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More and more people when turning 65 and receiving Medicare are signing up for Medicare Advantage Plans.  In large cities with large hospital networks, it is very attractive.  People who are in relatively good health enjoy the $0 monthly premium that many of these plans have along with the prescription coverage and extras like dental and gym memberships etc.

 

However, the operative word is healthy.  The Medicare Advantage Plans are a pay as you go type plan with co-pays and co-insurance.  One nice feature they share is an out-of-pocket maximum for the year in case of a bad health year.  In 2021 the maximum MOOP was as high as $6,700.  Original Medicare, which these Medicare Advantage Plans must be as good as or better, don’t have an annual maximum out of pocket.

 

Rookie FACT: Research from Kaiser Family Foundation has shown that 92% of people will never hit the out of pocket of maximum, but for those that do, it usually is a result of two things.  Hospital stays or radiology for chemo and cancer.

For example, Hospital co-pays can range in the $300 per day for days 1-5 and can happen multiple times upon new readmittance to the hospital. Most costs for Medicare Advantage Plans are as co-pays but co-insurance of 20% will be seen for such things as radiology and air ambulance on most plans.  When you have a $30,000 chemo charge for the month, you can see why that 20% co-insurance can reach the out-of-pocket maximum quickly. 

 

To offset these out-of-pocket costs people, use Hospital Indemnity plans or cancer plans to help pay that maximum out of pocket. 

 

Insurance companies offer low monthly premiums for those turning 65 with no underwriting necessary to cover hospital co-pays like the $300 for days 1-5.  Likewise, for cancer, individuals can receive lump sum payments on the first diagnosis of Cancer to help pay the maximum out of pocket expense they will have.  Also, the extra money can be used for things your Medicare Advantage Plan or Medicare will not cover like travel expenses or expenses with extra help at home.  See below chart for two plans from GTL General Trust Life.  Click here for GTL brochure.

 

 

 

This extra coverage for cost of premiums makes the Medicare Advantage Plans more attractable and give you peace of mind.  Another plus is that you still have a substantial savings from paying for a Medicare Supplement and Prescription plan premiums. 

 

For more information on these types of plans just click on the No-Cost Consultation button below to submit your information or contact us at 

216-659-7230 or by email at dave@evergreenrs.net

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