Pros and Cons of Medicare Advantage Plans

Photo of author

( — August 1, 2019) — Medicare advantage plan is an alternative plan that can work in the place of Original Medicare plan though with some payment. Medicare advantage plans usually have premiums that vary from one plan to another because they are usually provided by the insurance companies and the insurance companies are responsible of determining the amount of money that you will pay as copays and premiums.

Unlike the traditional Medicare, the Medicare advantage plans usually cater for prescription and drug supply. And with the new Medicare advantage plans for 2020, it seems the popularity will continue to increase. It has all the benefits that the Original Medicare and even more as we are going to identify in this article. Medicare advantage plans have many advantages but just as anything they have their downsides too.


Some of the advantages of Medicare advantage include;

  • Lower cost premium– When it comes to monthly premiums the Medicare advantage plans just happens to be the lowest. For some plans you will be required to pay $0 dollars. You saw it well zero dollars! But you but don’t get too excited because the Medicare advantage plan only pays for your medical bills and you will still need to settle your original Medicare part B premiums.
  • Annual limit– The Medicare advantage plan usually have a certain limit set and when you reach the limit you can get the services for free because they are going to cater for it. It is not as complicated as it sounds. Let me give an example for easier understanding. If for example is set at 3500 dollars this year, if you get seriously sick (God forbid) and then you end up using 8000 dollars for medication, the Medicare advantage plan is going to cater for the excess of 4500 dollars.
  • Unique benefits – the Medicare Advantage has very unique benefits that the Original Medicare doesn’t have, these includes; drug prescription and other unique benefits like, vision coverage and dental coverage. If you want prescription and drug coverage when you are using your traditional Medicare plan, you will have to purchase the part D plan and of course it comes at a monthly premium.
  • Convenient- the Medicare advantage plans are usually very convenient. Since they are offered by private companies different plans have different benefits. Each company wants to choose their plan meaning they always strive to provide you with the best care. Also unlike the original Medicare where you will need to purchase a plan D as well as a Medigap plan for maximum coverage, the Medicare advantage plan is all in one! It is no wonder it is a top choice for many seniors.


  • Regular change in benefits-the change of benefits every year is not conducive for some people. Like for example the annual limit keeps on changing and after each year it keeps on increasing. As of 2019 it is at 6700 dollars. It is very hard to use such huge amounts of money in one year. And the new Medicare advantage plans for 2020 has new changes. Like for example after they take effect you will be required to pay some dollars in order to see a doctor. This changes can be frustrating to many people.
  • You cannot be treated out of the network- unlike when you are using an original Medicare plan where you can receive treatment from any doctor who accepts Medicare assignment, with the Medicare advantage plan you can only use the company’s doctors, labs, pharmacies etc. if you are treated out of network, and you may incur unnecessary charges. But in case of emergency you can receive treatment out of network.
  • Specific enrollment periods. When it comes to enrolling for the Medicare advantage plan, there are specific times for that. Most of the plans usually offer prescription and drug coverage but just in case you choose one that does not offer those benefits, you will have to wait until the open enrollment is available to change or drop the plan. It can be quite frustrating when you are not receiving your vital medications and you have to wait for a year to drop or change the plan.