A good purchasing strategy can help you find the best Medicare Advantage plan, even in a changing climate

Mark Vallet | June 14, 2011

It can be hard to keep track of all proposed modifications to Medicare and Medicare Advantage, and how they will affect you. An overview of the Medicare system can help you understand the differences between health insurance plans, and guide you to the best Medicare Advantage decision.

Original Medicare consists of Part A, which generally covers hospital stays, nursing and hospice care, and Part B, which covers doctor's office, clinic and emergency room visits. There's a separate Part D option, which covers prescription drugs.

Medicare Advantage choices abound

Medicare Advantage plans take the place of original Medicare. Health insurance companies contract with the federal government to provide Medicare Advantage. There are numerous plans to choose from, and deductibles, co-payments and premiums vary depending on the plan you choose.

The Kaiser Family Foundation (KFF), which is a non-profit that researches health policy issues, reports 24 percent of the people on Medicare are enrolled in a Medicare Advantage Plan. The number of beneficiaries in private plans has grown to 11.1 million, up from 5.3 million in 2005, according to KFF.

Play your part in Medicare Advantage politics

Changes to Medicare Advantage are afoot. When passed in 2010, the Patient Protection and Affordable Care Act (PPACA) called for subsidies to be reduced and then eliminated. Scheduled to start in 2012, the subsidies will be phased out over the next 10 years, slicing an estimated $145 billion out of the program, according to an Associated Press report.

Of course, anything could happen. The centerpiece of health care reform, PPACA is a source of continued political debate and maneuvering. Staying abreast of news on websites and in newspaper pages will give you the most current information, and voting in elections makes sure your voice remains a part of the political process.

Choosing Medicare Advantage plans

Although it is expected that there will be 13 percent fewer Medicare Advantage plans offered in 2011, consumers will still have an average of 24 plans from which to choose, according to the KFF. Deciding which plan is right for you is a personal decision and should be given serious thought.

Start with these four basics:

    • Know your personal needs: Assess your current and future medical needs. Create a list of must-have services. And remember, your medical needs will probably not be the same as your spouse's.

    • Create a budget: Calculate how much you can comfortably afford to spend on health care, and stay within your budget when picking a plan. Premiums vary. Once you know how much you can spend, shop around.

    • Check your prescriptions: Certain Medicare Advantage plans include prescription drug coverage (Part D). They are often called MA-PDs. If you are interested in a Medicare Advantage plan that includes prescription drugs, check the list of drugs covered to make sure your current medications are on the list.

    • Don't scrimp on research: Use all of the research options available to you, including the official Medicare website.

    Tags : health insurance, health insurance mandate, medicare advantage, ppaca, kaiser family foundation

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