ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

What Is Medicare Advantage? Is It Better Than Regular Medicare?

Updated on July 21, 2021

Medicare Advantage Offers More, But At A Higher Cost To Government

What is Medicare Advantage, and should I enroll in it? Is regular Medicare coverage just as good? What are the differences? Medicare Part C is the portion of Medicare that covers Medicare Advantage programs. This article will try to explain it in layman's terms, ignoring the complex and concentrating on the practical. Many do not understand the different options that seniors have offered to them, so I will try to make this as simple as possible. Medicare Advantage, for the patient, can be a welcome alternative to traditional Medicare, but it does have some problems. It is not perfect and does cost more money for the government to offer.

The federal government pays private insurance companies over $1,000 per year for each of the 11 million current enrollees. This payment is over and above the normal costs of Medicare that are paid to the companies. It is a bonus, if you will. Eleven billion dollars per year is a pretty big bonus. What do seniors get for the bonus? Depending on the plan they enroll in, they can get plenty! Some plans offer dental coverage, comprehensive vision coverage, acupuncture and chiropractic services, while still others offer gym memberships. In other cases, not so much. The cost of Medicare Advantage to the beneficiary is generally less than traditional Medicare coverage. Instead of the usual 80/20 split as in Medicare Part B (outpatient services), there is often a $5.00 to $20.00 copay for office visits. That alone usually saves money.

Medicare Advantage HMO's

Most of the 11 million Advantage enrollees are covered under HMO plans. The plans mirror those offered on the commercial market. Secure Horizons, Kaiser Advantage, Scan are just a few of the plans in existence. Once enrolled, a Medicare recipient has no need to buy a supplemental insurance policy.

In order to enroll in a Medicare Advantage plan, the beneficiary must first enroll in Medicare Part A, Part B and Part D. Once that enrollment is complete, enrollment in a Medicare Advantage plan is possible.

Since these plans are generally mirror images of the commercial products, the problems are the same, or can be. Depending upon the choice of network and primary care physician, authorizations can take time. In virtually all cases, the primary care physician is the gatekeeper. He or she will determine what specialists are seen and he or she will also coordinate what testing is done. The Medicare recipient also gives up the right to see any or all of the doctors they choose. Their complete care regimen is controlled by their primary care physician.

With Medicare Advantage, you cannot go to doctor after doctor for the same problem. You will not be getting a CT scan ordered by each doctor you see. Your care will be highly coordinated and utilization will be monitored.

Why Write About This Now?

With the Ryan budget plan, now the GOP budget plan, being adopted by the entire right side of the aisle, Medicare Advantage programs come front and center. They are run by private insurance companies, and although President Obama has been accused by the GOP and others who are uninformed of cutting $500 Billion dollars from Medicare, those cuts came mostly from attempts to rein in and discontinue the government bonuses paid to private insurers for Medicare Advantage. None of that $500 Billion dollars came from cuts to services covered by the original Medicare plan. You may have heard different, but what you heard was a lie!

Perhaps the most clearly written explanation of the cuts in the Affordable Health Care Act come from another hubber on this site: Deni Edwards. The link to her comprehensive article is: .

It is a great article and should be read by all!

Finally, if I was a Medicare-eligible senior, I would enroll in a Medicare Advantage program in a hot minute. It would save me money. BUT, and that is a capital BUT, I have worked my entire life in the health care field. I know which plans are good and I also know my way around the private insurance maze. I know how to fight delays in authorizations; I know how to fight claims denials. I do not consider myself a lay person.


This website uses cookies

As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

Show Details
HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
LoginThis is necessary to sign in to the HubPages Service.
Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
AkismetThis is used to detect comment spam. (Privacy Policy)
HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
MavenThis supports the Maven widget and search functionality. (Privacy Policy)
Google AdSenseThis is an ad network. (Privacy Policy)
Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
Index ExchangeThis is an ad network. (Privacy Policy)
SovrnThis is an ad network. (Privacy Policy)
Facebook AdsThis is an ad network. (Privacy Policy)
Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
AppNexusThis is an ad network. (Privacy Policy)
OpenxThis is an ad network. (Privacy Policy)
Rubicon ProjectThis is an ad network. (Privacy Policy)
TripleLiftThis is an ad network. (Privacy Policy)
Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
ClickscoThis is a data management platform studying reader behavior (Privacy Policy)