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Want to know how to compare Medicare Advantage plans in 2020? Read on to learn what to look for when selecting the coverage that's right for you.

By Joseph Arroyo
Updated June 5, 2020

Key Takeaways:

  • Many Medicare Advantage plans don't have premiums, and if they do, they should be an affordable amount.

  • It's best to compare copays, coinsurance and out-of-pocket maximum costs and limits when comparing plans.

  • Check to see if your primary care doctor is in-network. Also, look for any specialists you see. You will save money on co-pays if you take this simple comparison step.

  • You may be drawn to the plan with the most extra benefits, but consider which of them you are most likely to use.

There are more than 3,000 Medicare Advantage plans out there, so figuring out which plan is right for you can be overwhelming. Medicare Advantage plans are popular with people entering Medicare. How can you compare them?

As an independent health insurance agent, I help my clients sift through the huge number of plans with a few simple criteria. I'll share them with you below.

How To Review Medicare Advantage Plans

Think local.

When looking at Medicare Advantage plans, the first thing to keep in mind is that these are local plans. They are generally available only within a specific county. Rarely will you see a Medicare Advantage plan designed for an entire state.

Rarer still are Part C plans (another name for Medicare Advantage) that provide coverage throughout two states. Make sure you're comparing only plans available to you.

Think beyond basic coverage.

The next thing to consider is that every Part C plan must cover what Original Medicare covers. This means the major benefits will be the same for every plan.

The basic coverage will be identical, but there are many variations for you to consider.

Think through the three wild cards.

When comparing the core coverage, you'll want to look at these areas:

  • Monthly premium

  • Annual deductible for medical services

  • Annual deductible for drug coverage

An easy way to sort your Part C options is to look at the premium. Many Medicare Advantage plans don't have a premium at all. Any premium should be an affordable amount. Also, many plans don't have a deductible. All else being equal, why pay more for coverage if you don't have to? Also, having coverage from day one, rather than having to meet a deductible first, can be a real plus.

Compare Medicare Advantage Costs for Services

Whether a Part C plan has a premium or deductible, it will certainly have some elements of cost sharing. You should compare these costs and limits:

  • Copays

  • Coinsurance

  • Out-of-pocket maximum

Every Part C plan can set its own copays and coinsurance as long as it meets Medicare's requirements. So, two plans could have different copays for the same service. Compare the costs of some of these higher-dollar items:

  • Part A inpatient hospital copays

  • Part B outpatient surgeries

  • Emergency transportation like ambulances and life flight

Your Routine Health Needs

In addition to these, think of your routine, "normal" needs. Maybe you see your primary care physician only a few times per year, but you see a specialist regularly. In this case, compare plans to see which ones have the lowest copay to see a specialist.

Another key number to look at is the out-of-pocket maximum (OOPM). This is the maximum amount you could spend in one calendar year. If you reach this amount, the plan will pay 100% of all other Medicare-approved costs the rest of the year. All other things being equal, look for the lower OOPM.

Your In-Network Providers

A last, very important coverage detail is to make sure your doctor accepts the plan you choose. Most Medicare Advantage plans are either HMO or PPO based.

In an HMO, you must use network providers. Otherwise, the plan won't cover the service or procedure. A PPO offers lower pricing if you use network providers (they are "preferred"), but you can see non-network providers if you don't mind paying more.

Check to see if your primary care doctor is in-network. Also, look for any specialists you see. You will save money on copays if you take this simple comparison step.

Compare Medicare Advantage Plans Based on Extra Benefits

Medicare Advantage plans often come with extra benefits. These benefits are for services not covered by Original Medicare. Every Part C plan has its own mix of extra benefits. It's important to keep in mind these benefits are not guaranteed. They can also vary by state. Some common extra benefits include:

  • Vision and hearing coverage

  • Basic dental coverage

  • Comprehensive dental available for additional premium

  • Fitness benefits

  • Transportation

  • Meal delivery programs

  • Emergency coverage outside the United States

  • Acupuncture

  • Chiropractic care

  • Podiatry coverage

  • More every year

You might be drawn to the plan with the most extra benefits. However, I counsel people to consider which of them they're most likely to use. Maybe having an acupuncture benefit is a real luxury for you, but you're not interested in a fitness membership.

More clients ask me about acupuncture than any other extra benefit. Another is chiropractic coverage. Medicare doesn't cover routine chiropractic services. Getting these benefits from your Medicare Advantage plan can save you a lot of money.

The last extra benefit I would draw your attention to is worldwide emergency coverage. Not all Medicare Advantage plans offer this. But, some do, especially in border states. If you plan to travel outside the US often, having emergency coverage from your Part C plan might allow you to skip buying travel insurance.

Joseph Arroyo is a licensed Medicare insurance specialist who lives in Hilton Head, South Carolina. Arroyo is certified to sell Medicare products including Medicare Supplement insurance, Medicare Advantage, and prescription drug plans.