Aspirus Health Plan shares five important considerations when choosing a Medicare Advantage Plan

Posted 11/27/24

With Medicare’s Annual Election Period (AEP) now open, Aspirus Health Plan wants to help Medicare beneficiaries navigate the decision-making process of selecting a Medicare Advantage (MA) plan …

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Aspirus Health Plan shares five important considerations when choosing a Medicare Advantage Plan

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With Medicare’s Annual Election Period (AEP) now open, Aspirus Health Plan wants to help Medicare beneficiaries navigate the decision-making process of selecting a Medicare Advantage (MA) plan by sharing key considerations that everyone should review when choosing their plan.

“Medicare’s Annual Election Period for 2025 ends on December 7, 2024, so it is important that you evaluate your options and select coverage that will best meet your needs before the deadline,” said David Bittner, Interim President Aspirus Health Plan. “We encourage everyone to compare plans carefully and reach out to trusted resources if they need further assistance.”

Medicare Advantage plans, like those offered by Aspirus Health Plan, offer an alternative to Original Medicare and can provide additional benefits. Here are five of the most important factors to consider when evaluating a Medicare Advantage plan:

  1. Healthcare Provider Network: Medicare Advantage plans typically have a defined network, such as an HMO or PPO. It’s essential to confirm that your preferred doctors, hospitals, and specialists are in-network and accessible under the plan you're considering. Staying within the network usually results in the lowest out-of-pocket costs.
  2. Cost Structure: Medicare Advantage plans can vary in terms of monthly premiums, copays, deductibles, and annual out-of-pocket maximums. Keep in mind that while some MA plans have low or even $0 premiums, the cost structure for services may differ between plans.
  3. Prescription Drug Coverage: Many Medicare Advantage plans include Part D prescription drug coverage. It’s important to review the list of covered drugs to ensure your medications are included and to compare associated copays or coinsurance costs.
  4. Plan Type and Flexibility: Consider the type of plan, such as Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), and if it fits your lifestyle. HMOs typically require referrals for specialist visits and may only cover services from in-network providers. PPOs offer more flexibility to see providers outside the network, although at a higher cost.
  5. Additional Benefits: Unlike Original Medicare, MA plans often offer additional benefits like dental, vision, hearing, and wellness programs. These extra services may add significant value, especially for those who need specific services not covered under Original Medicare.

“We know that choosing a Medicare Advantage plan is a highly personal decision,” said David Bittner. “By considering your network preferences, cost structure, and any additional benefits that might be valuable to you, you can find a plan that aligns with your personal healthcare goals.”

You can find more information about Medicare Advantage options and how to find the right plan by visiting www.healthcare.gov or the Aspirus Health Plan website.