AARP offers a Medicare Advantage plan for the elderly population of the country with a variety of options. You can choose one plan that best suits your budget and needs.
AARP Medicare Plan offers the Medicare Advantage plan (Part C) with a variety of options with different types and costs with the basic services like products that cover original Medicare plans with additional benefits such as vision, hearing, and preventive care services. The prices of the plans vary from place to place. Also, you need to check quotes by visiting comparison websites that can offer you a good insight into different healthcare plans offered by different sites.
Prices of the plan for people of age 60s are pretty high which keep reducing with the time and the plan offers cheapest prices for the policies bought by the people of age 80s and 90s. AARP Medicare Plan is a good option for getting one convenient healthcare policy.
Table of Contents
- 1 What is Medicare?
- 2 Parts of the Medicare program
- 3 AARP Medicare advantage plan
- 4 AARP Medicare Advantage plan coverage
- 5 AARP Part D options
- 6 Advantages of Medicare Advantage plan
- 7 Disadvantages of Medicare Advantage plan
- 8 FAQs about Medicare Advantage
- 9 Conclusion
What is Medicare?
The United States federal government subsidizes the health insurance program for people of age 65 and above or those less than this age who qualify certain eligibility criteria is what constitutes the medicare program. It is divided into different plans that cover a variety of areas related to health issues that give the consumers choice in terms of cost and coverage that befits their needs.
Health-care costs have remained a worrying issue in the United States for years, people are worried if they won’t be able to pay the cost of medical bills or insurance costs. Keeping this situation in view, the federal government has initiated this healthcare program to protect the health of citizens of America who can benefit from government-backed Medicare services. The program is administered by the Centers for Medicare and Medicaid Services (CMS) around the country.
Parts of the Medicare program
It might get confusing to sort out the program because of the complexity of the process. To make it easier, the program is divided into four parts that provide coverage for everything related to your health issues from hospital care, doctor visits, and prescribing drugs.
Part A: hospital coverage
When you first apply for medicare, you are directly enrolled in part A that covers the hospital expenses. For instance, if you have broken your leg, or you have experienced a stroke or other health condition that needs rehabilitation in a nursing home and it requires some days’ stay at the hospital. Most people don’t have to pay the premiums for part A because it already gets paid as a form of medicare tax deductions of your paycheck when you applied in the system.
However, it is not totally free, you have to pay the deductibles every time you are enrolled in the hospital. The hospital coverage usually covers hospital bills, or similar inpatient or inpatient like services such as skilled nursing facilities, home-based healthcare, and hospice but long-term or custodial care is not included in the coverage. Those who receive social security benefits get the coverage automatically but those who don’t receive benefits can enroll themselves on the social security website.
The deductibles keep on changing every year, for 2022, the deductible is $1,556. So you need to check the number of deductibles when you apply.
Part B: doctor and outpatient services
You get coverage for the services like doctor visits, lab tests, medical equipment, diagnostic screening, mental health coverage, ambulance transportation, and other outpatient services. Some prescription drugs are also covered under this part.
The standard monthly premium for Part B is $170.10 in 2022. It also keeps on changing so you should check first before applying. The annual deductible is $233 this year. However, individual taxpayers whose modified adjusted gross income is more than $91,000 pay higher premiums. Also, married couples whose modified adjusted gross income is more than $182,000 pay higher annual premiums.
Part C: medicare advantage
Individuals who are eligible for Medicare part A and B are likewise eligible for part C which is called the medicare advantage that individuals get from private insurers and not from the government itself. Individuals have to purchase Medicare Advantage plans that at least offer coverage equal to original medicare (Part A and B).
Many of the plans offer annual limits on out-of-pocket costs and may also provide benefits that are otherwise not provided by the original Medicare program and people have to buy via supplemental insurance such as the Medigap plan. Some of them may include coinsurance copays, deductibles, and even costs related to insurance while you travel outside the country. You may also get other offers such as vision, dental and hearing care.
Medicare Advantage plans are generally health maintenance organizations (HMOs) or preferred provider organizations (PPOs). In HMOs, you get to see a primary care doctor who will heal your health condition and then can refer you to see a specialist. PPOs however, have networks of doctors that you get the chance to see without requiring any referral.
Part D: prescription drugs
Like Part C, you also have to purchase Part D which will be covered for some of your prescription drugs. Each generally has certain premiums, other out-of-pocket costs, and annual deductibles that you need to pay. For instance, if the total amount of drugs reaches $4,430, you will have to pay 25% of the price you will be buying during the rest of the year.
AARP Medicare advantage plan
The American Association of Retired People (AARP) is an advocacy group that takes care of the issues faced by the elderly population of the country. They provide benefits to its members and offer different medicare plans with different benefits and costs. As Medicare Advantage is a type of health insurance that is provided by private insurance companies, AARP offers Medicare Advantage plan (Part C) with the basic services like other products that cover original Medicare plans with additional benefits such as dental, vision, and preventive care services.
If you plan to choose an AARP Medicare Advantage plan, you need to check different prices of the plans which vary from area to area. Getting a price quote based on your situation can help determine which plan will suit you the most. Although the prices of AARP Medical supplements are higher than other companies, they offer a variety of choices that make your selection easier and they are good.
The price for a 60-year old individual may be higher but it gets lower with time and offers the cheapest plan for people in their 80s and 90s. This reduces the overall lifetime spending.
AARP also offers low-priced Medigap plans for those who want discounts on their insurance plan that limit some coverage to in-network healthcare providers and other facilities. If you get the discount, you can save $200 to $250 per year on the insurance cost that is provided by UnitedHealth care’s large network of healthcare providers.
In 2022, AARP offers HMO, HMO D-SNP, PPO, and PFFS plan options that are available nationwide. Below is the list of plans offered by AARP. Check each one of them before enrolling yourself for any of them.
AARP HMO plan
AARP Medicare advantage offers a variety of HMO plans. Under this plan, you will get to choose your primary physician who will take care of your health issues for more of the time. If you need to visit a specialist, this primary physician will provide a referral that you will need to see the specialist. But it is not always the case. In some cases, such as if you need flu shots, vaccines, or preventive women’s healthcare services, you can get yourself from the specialist without any referral from the primary care doctor.
Under this plan, you are not provided the coverage for out-of-network healthcare providers unless you have experienced the below situations:
- It’s an emergency
- You need dialysis and you are traveling outside the plan’s service area
- The care you need under the medicare plan is not available who can provide the care you need in your network
AARP HMO D-SNP plan
AARP Medicare Advantage provides HMO Dual Eligible Special Needs Plans (D-SNPs) in many areas in the country, especially those people who are eligible for both Medicaid and Medicare.
Most of the HMO D-SNP have no premiums, copays, or deductibles but they offer many important benefits such as:
- 60-one way trips to a healthcare provider in a year
- Renew active fitness membership
- A personal emergency advice
- $350 quarterly credit for over the counter medical supplies and approved wellness products
- Hearing aids
- Eye exams and eyewear
- 20 chiropractic or acupuncture visits per year
- Routine and comprehensive dental care
- No-cost or low-cost prescription drugs
- telehealth/virtual health visits
AARP PPO plan
AARP Medicare Advantage offers Preferred Provider Organization (PPO) plans for the customers in many markets where you have a flexible choice to choose a healthcare provider within the available network or outside of the network. If you get one from within the network, the cost that you have to pay would be lesser.
Also, you don’t need a referral from a primary healthcare provider if you need to see a specialist.
AARP PFFS plan
AARP Private Fee For Service (PFFS) works differently than ordinary Medicare Advantage plans. In this plan, the insurer sets a fixed amount for each medical service which means if the doctor doesn’t accept the set fee, they won’t pay you extra. That means your doctor has the option of providing some services to you and not others. He can provide a service that can only be compensated within the set fee from your insurer.
The plan covers the same items of services that are being covered by the Part C of the Medicare program. Being the part C plan, they can also provide additional benefits that can vary from plan to plan. Also, you have the flexibility to see any doctor as you don’t need any referral for seeing a specialist.
Note that premiums for the plan are sometimes higher than other plans and PFFS are not offered in every area.
AARP Medicare Advantage plan coverage
AARP Medicare Advantage provides the benefits covered in original Medicare (Part A and B). besides that, it also provides additional coverage in the below areas:
- Eye exams and glasses or contact lenses
- Hearing aids
- Annual physical examination
- Flu shots and other required vaccines
- Preventive and comprehensive dental care
- Fitness program and gym membership
- Virtual visits/telehealth
- 24-hour nurse hotline
In addition, the standard hospital and outpatient medical care is also covered in the Medicare Advantage plan because it has to match the original medicare plan that also gives you other benefits like those mentioned above. Along with this extra coverage, some policies may also offer alternative health services such as acupuncture and chiropractic care.
In order to get confirmation, you need to read the policy documents very carefully.
AARP Part D options
AARP offers three distinct plans for 2022:
- AARP MedicareRx Preferred: With low deductibles, this part D plan offers a wide network of pharmacies that can help citizens across the country.
- AARP MedicareRx Walgreens: This plan has low premiums and provides additional savings if prescriptions are filled at Duane Reade and Walgreens locations.
- AARP MedicareRx Saver Plus: This plan offers low premiums and low deductibles
Many of the Medicare Advantage plans offer prescription drug coverage as an additional benefit. If you want to have this coverage included in your package, you can select this option while searching in your plan offered in your area.
Advantages of Medicare Advantage plan
The Medicare Advantage plan provides many benefits such as:
- Some home healthcare services
- Doctor’s visits
- Preventive care
- Prescription drug coverage
- Hospice care
- Fitness membership
Compared to original Medicare, you can get additional benefits if you choose the Medicare Advantage plan including:
Convenient coverage options
If you purchase an original Medicare plan, you will get two types of coverage; hospital insurance and medical insurance. For getting additional coverage, you need to buy Medicare Part D separately for prescription drug coverage and Medigap if you want supplement coverage. But if you buy a Medicare Advantage plan, all of your plans are covered under one convenient program.
By purchasing a Medicare Advantage plan you can save your money as many advantage plans have no premiums and offer low deductibles. Also, as most of the plans set limits on maximum out-of-pocket costs you’ll pay during a plan year, you get the benefit of not spending unpredictable money.
You may save money on laboratory service and medical equipment if you buy a Medicare Advantage plan as you get a flexible option to choose from under the HMO network plan.
Personalized plan structure
With a Medicare Advantage plan, you are offered a variety of plans based on your personal health condition. For instance, if you are going through some chronic health condition, an SNP Advantage plan may help you. If you want to have freedom for health providers, you can opt for PFFS or PPO and if you are looking for extra services such as hearing, vision, and dental, the Medicare Advantage plan will work for you in a great manner.
Coordinated medical care
When you have a Medicare Advantage plan, you get to be served by a network of healthcare providers who constantly remain in contact with you and help you get the specialized service if you need it in some cases. They ensure that you have a healthcare team that looks after your health and also help you avoid unnecessary expenses, issues like medical interactions
Disadvantages of Medicare Advantage plan
While most people are satisfied with the Medicare Advantage plan, there are some limitations for which some people prefer the original medicare plan over the Medicare advantage. Here are some of the disadvantages of Medicare Advantage.
Limited service providers
If you are choosing one of the Medicare plans such as the HMO plan, it provides a limited network of healthcare providers, and sometimes you don’t get the provider that can help you in the network. And if you choose any provider outside of the network, it can cost you more charges than what you could have gotten within the network.
You can get more providers from other plans but you have to pay higher premiums, fees, copays, and deductibles.
Additional costs for coverage
Buying original medicare may cost you premiums, deductibles, and coinsurance for both parts A and B beside any part D and Medigap cost. But if you notice, there are some additional fees in Medicare Advantage along with these charges such as many Medicare Advantage plans include drug deductible and specialist visit copays.
Complex plan offerings
If you use Medicare’s “find a plan” tool to look for a specific Medicare Advantage plan, you will notice that there are so many options available for Medicare Advantage plans depending on the ZIP code. For some people, it can be an overwhelming practice especially if you are a busy person and want easy access to get the plan.
Original Medicare offers the same cost for the policy across the country but the charges of Medicare Advantage are not the same and they offer specific coverage in specific areas. The biggest disadvantage you can have with this policy is that if you move to a new service area, you can lose your current Medicare Advantage plan.
FAQs about Medicare Advantage
If you are planning to purchase a Medicare Advantage plan, ask yourself these questions in order to choose the best policy option.
- How much did I spend on my healthcare last year and a year before?
Answering this question may help you determine the budget for the plan and how much you can pay for the premiums and out-of-pocket costs. Although some plans may offer $0 for premiums and deductibles, you may be charged for some other plans.
- What types of coverage do I need?
There are many Medicare Advantage plans that offer additional benefits such as vision, hearing, and dental. You need to check out from the providers if they provide this additional coverage in your plan so you can get them.
- Does my healthcare provider accept Medicare or do they practice in an HMO network?
If you want to keep your current healthcare provider for your future checkups, you will need to know what medicare plans they accept and participate in.
- What prescription do I take or will I need?
If you already take some prescribed drugs, you need to find a medicare advantage plan that includes prescription drug coverage or purchase a part D plan and search for the drug lists to confirm that your medications are covered.
- What medical conditions do I have and what are my long-term healthcare needs?
As the study suggests, more than 40% of Americans have chronic health conditions. It is important to see what is your health condition or if you have any disease so that you would be able to choose a plan that best suits your medical needs.
- What is the CMS rating for the plans I’m considering?
The Centers for Medicare and Medicaid Services (CMS) uses a five-star rating system to measure the quality of services provided by the Medicare Advantage and part D plans. It is important to look for the ratings of the programs you plan to purchase because it is based on the consumers who have already used the services. The CMS star rating measures things such as management of chronic conditions, member experience and complaints, availability of care, drug pricing, customer service, and more.
Lofty medical bills and expensive medicare services have been a worrisome issue for the people of the United States especially for elderly people who have limited income resources after their retirement. Given this situation in the country, American Association for Retired Persons (AARP), a non-partisan and nonprofit interest group, works to address the issues of elderly people. It offers Medicare services to its members and non-members which is a great deal of help for this section of the population.
If a person is eligible for Part A and Part B of the Medicare plan, they can apply for AARP Medicare plans. Also, if they apply for the AARP Medicare Advantage program, they get one convenient package of healthcare where they get Part C services with the original medicare plan.