Top 5 Myths About Medicare Advantage Plans

You may have some ideas about Medicare Advantage Plans based on what you have heard from friends and family. If you have been on traditional Medicare or you are ready to switch from employer coverage to Medicare, we want to help dispel myths about Medicare Advantage Plans that could keep you from choosing the right plan for your needs. Kupuna have until December 7 to switch to a Medicare Advantage Plan for coverage starting January 1, 2022.

Top 5 Myths About Medicare Advantage Plans


Myth #1: Medicare Advantage Plans are more expensive than Original Medicare


Medicare Advantage Plans are much more affordable than you may realize. For one thing, many Medicare Advantage Plans come with a $0 monthly premium. When we take a look at overall out-of-pocket expenses, Medicare Advantage Plans can actually offer a savings over Original Medicare because they cover more services - such as dental, vision and hearing - and come with an annual out-of-pocket maximum. (Original Medicare does not cover dental, vision and hearing and has no annual out-of-pocket maximum.) Better Medicare Alliance, the leading research and advocacy group supporting Medicare Advantage, released an analysis this year conducted by ATI Advisory showing that Medicare Advantage beneficiaries report spending $1,640 less in their total annual health spending than those who are enrolled in Original Medicare.


Myth #2: I can change Medicare Advantage Plans whenever I want


Medicare Advantage Plans come with an annual enrollment window so you cannot switch plans whenever you want. The AEP is between October 15 and December 7 each year. If you enroll in a plan during this window and discover that it is not meeting your needs once it goes into effect on January 1, you have a one-time opportunity to make a switch or drop coverage between January 1 and March 31. You cannot, however, switch from Original Medicare to Medicare Advantage during this second window so it’s important to choose an Advantage plan during AEP.


There are also certain life events that qualify seniors to sign up for a new plan during a special enrollment period, such as a move.


Myth #3: My Medicare Advantage Plan will stay the same once I sign up


Medicare Advantage Plans can change from year to year; you cannot expect to be grandfathered into the current version of your plan. Changes to premiums, deductibles, copayments, coinsurance, prescription drug coverage and even your health provider network could show up in the Annual Notice of Change (ANOC) document you should receive by the end of September each year. If you don’t receive a letter, it is a good idea to check with your Medicare agent or call the plan to confirm whether any changes are coming.


Myth #4: It doesn’t matter which Medicare Advantage Plan you choose because they are all essentially the same


In 2021, there are 3,550 Medicare Advantage Plans available nationwide with significant differences among them, including:

  • Premiums, copays, coinsurance, and deductibles

  • Extra benefits such as dental, medical transportation, and fitness programs

  • Health provider networks

  • Plans catered to chronic conditions

  • Prescription drug coverage

Talk to a trusted Medicare agent to discuss your options and which plans could work well for you.


Myth #5: I have to change my Medicare Advantage Plan every year

If you are happy with your current plan and are comfortable with any changes that may be coming to it next year, then you are not obligated to do anything. Your health plan will automatically renew for you if you do not make a change during Medicare’s Annual Enrollment Period (AEP), October 15-December 7.


On the other hand, you have an opportunity to explore your options and make a switch to a different Medicare Advantage Plan or to Original Medicare during AEP each year. Your new coverage begins January 1 of the following year.


We are in the last few days of the enrollment period; please contact a Medicare agent with any questions as soon as possible.


Contact a PBC Agent for Help


Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.


At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.