How Medicare Advantage Plans Differ from Traditional Medicare

Hook Law Center (formerly Oast & Hook)

Virginia Beach, VA (Law Firm Newswire) November 20, 2015 – Medicare Advantage plans are part of the Medicare program in which one is still entitled to the same rights and protections as if one had traditional Medicare. They are private plans that may offer more benefits than those accessible in traditional Medicare, and sometimes at no extra cost to beneficiaries.

Medicare Advantage plans may be able to operate with more efficiency than the traditional program, purchasing additional benefits for a lower cost, and regulating care in such a way as to ensure that patients make use of medical services more economically.

“Medicare Advantage plans have become increasingly popular because they sometimes offer more benefits than traditional Medicare, and can even be less costly to patients,” said Andrew H. Hook, a Virginia life care planning attorney with Hook Law Center, with offices in Virginia Beach and northern Suffolk. “Choosing the right Medicare plan for the individual, whether it is Medicare Advantage or traditional Medicare, is one aspect of a life care plan that can help seniors maintain or improve their quality of life.”

There is evidence both for and against the claim that Medicare Advantage plans are more efficient than traditional Medicare. The Medicare Payment Advisory Commission revealed that in 2014, Medicare Advantage plans were able to offer the same benefits as traditional Medicare for a cost that was two percent less.
However, several studies indicate that patients enrolled in Medicare Advantage are slightly healthier than those enrolled in traditional Medicare. Thus, part of the difference in cost could be attributed to the kind of patients who are attracted to Medicare Advantage, and not to a more efficient plan.

Some experts suggest that the Medicare Advantage program could be improved by having plans vie for enrollees in a way that resembles the Affordable Care Act. Plans could provide bids for coverage of Medicare, and then, in lieu of paying the plans the amounts that they bid along with an additional payment, the government could choose one of the less expensive bids, and pay that amount to each plan.