Questions that you may have about a Medicare Advantage plan

Medicare Advantage plans are the newest option for Medicare recipients. Prescription drug coverage is often included in the Advantage plan. These plans are available in 98% of counties in the USA.

Ten Common Questions about the Advantage Plan:

1) What Comprises Medicare Advantage Plans?

Advantage plans include the Preferred Provider Organizations (PPO), the Private Fee-for-Service (PFFS), and the Health Maintenance Organizations (HMO) plans. Medicare recipients may pick from the advantage plans in Medicare in their area. Private insurers manage the program.

2) How is eligibility determined?
Having Medicare Part A and Part B are required. End stage renal disease is the one disqualification. Otherwise, there are no medical questions.

Medicare Advantage Plan
Monthly Payments (Average)
Number Of MA Contracts
Advantage Plan Penetration
United States $734 United States 428 United States 17.5%
Alabama $692 Alabama 41 Alabama 15.2%
Alaska NA Alaska 39 Alaska 0.5%
Arizona $651 Arizona 50 Arizona 30.1%
Arkansas $640 Arkansas 39 Arkansas 8.23%
California $652 California 52 California 30.7%
Colorado $649 Colorado 37 Colorado 28.2%
Connecticut $681 Connecticut 40 Connecticut 9.1%
Delaware $658 Delaware 37 Delaware 2.23%
District of columbia $776 District of columbia 41 District of columbia 8.12%
Florida $840 Florida 74 Florida 23.1%
Georgia $680 Georgia 49 Georgia 8.1%
Hawaii $639 Hawaii 41 Hawaii 34.4%
Idaho $647 Idaho 40 Idaho 18.2%
Illinois $680 Illinois 56 Illinois 7.22%
Indiana $641 Indiana 45 Indiana 9.5%
Iowa $618 Iowa 42 Iowa 11.8%
Kansas $675 Kansas 44 Kansas 6.2%
Kentucky $653 Kentucky 45 Kentucky 8.4%
Louisiana $855 Louisiana 42 Louisiana 16.1%
Maine NA Maine 38 Maine 2.23%
Maryland $815 Maryland 41 Maryland 5.5%
Massachusetts $737 Massachusetts 42 Massachusetts 14.2%
Michigan $816 Michigan 44 Michigan 14.1%
Minnesota $645 Minnesota 40 Minnesota 26.2%
Mississippi NA Mississippi 38 Mississippi 6.51%
Missouri $663 Missouri 45 Missouri 15.2%
Montana $591 Montana 38 Montana 11.2%
Nebraska $650 Nebraska 37 Nebraska 8.21%
Nevada $757 Nevada 41 Nevada 29.1%
New Hampshire $653 New Hampshire 33 New Hampshire 2.1%
New Jersey $807 New Jersey 42 New Jersey 8.2%
New Mexico $651 New Mexico 41 New Mexico 20.1%
New York $811 New York 64 New York 21.2%
North Carolina $647 North Carolina 40 North Carolina 13.3%
North Dakota $591 North Dakota 37 North Dakota 5.51%
Ohio $674 Ohio 54 Ohio 17.1%
Oklahoma $666 Oklahoma 42 Oklahoma 11.3%
Oregon $647 Oregon 53 Oregon 34.3%
Pennsylvania $778 Pennsylvania 59 Pennsylvania 31.1%
Rhode Island $655 Rhode Island 37 Rhode Island 30.2%
South Carolina $646 South Carolina 43 South Carolina 8.22%
South Dakota $591 South Dakota 36 South Dakota 3.2%
Tennessee $655 Tennessee 47 Tennessee 16.1%
Texas $742 Texas 57 Texas 13.0%
Utah $644 Utah 40 Utah 16.5%
Vermont NA Vermont 34 Vermont 1.1%
Virginia $671 Virginia 43 Virginia 8.7%
Washington $644 Washington 47 Washington 19.1%
West Virginia $707 West Virginia 40 West Virginia 6.23%
Wisconsin $618 Wisconsin 46 Wisconsin 18.2%
Wyoming NA Wyoming 35 Wyoming 2.3%

3) Are Medicare Part B premiums required to be paid ($96.40 in 2012)?
Yes. Regardless of which Medicare Advantage Plan the Medicare recipient chooses, one will continue paying the Medicare Part D monthly charge.

4) Is the Federal government and Medicare still in charge?

Yes. The Federal government is the ultimate arbiter for all Medicare decisions. The Advantage plan member will have rights and protections that are protected by the Federal government.

5) Is the Advantage Plan complicated and difficult to understand?
No. The Medicare Advantage plan is simple with no hidden costs. Your out of pocket expenses will be the monthly premium as well as the co-payments and coinsurance amounts that are defined on the sales material and the Medicare Advantage plan contract

6) Why is the Medicare Advantage plan beneficial?
• Advantage Plans usually have lower co payments, lesser out of pocket expenses as well as extra benefits as opposed to the original Medicare plan.
• Little or no monthly premiums are available in certain parts of the USA.
• Part D prescription drug coverage is often included.
• A Medicare supplement is not needed, saving thousands of dollars per person.

7) Are there options available?
Yes. The various Advantage Plans all meet the government's strict regulations, but different plans will differ in consumer costs and Medicare coverage. Many options are available and it is worthwhile to analyze the available Medicare Advantage plans to choose the best plan for you.

8) Are there any enrollment restrictions?
There is a an enrollment beginning November 15, 2012 and ending March 31, 2012. Those who are not enrolled with a Medicare chart by March 31 will not be able to enroll in an Advantage plan till January of the following year.

9) Are Medicare Advantage plans required?

The Advantage plans are not required but the superior Medicare benefits being offered is certainly very hard to refuse.

10) What is the Prescription Drug Plan (Part D)?

The Part D prescription drug coverage can be included in the Medicare Advantage plan or can be purchased separately in conjunction with a supplement Medicare or the original Medicare. The prescription plan is insurance. Private insurers offer the coverage. You choose particular Part D plan and pay the premium. Medicare and the federal government is subsidizing the Part D premium.