Medicare vs. Medicare Advantage Plans: Essential Information for Healthcare Professionals Working with Older Adults

What is it about?

The difference between traditional Medicare and Medicare Advantage plans is explaind, with special attention to the relative strengths and potential drawbacks of each. This information is important to health carfe providers and Medicare-eligible patients.

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Why is it important?

Due to the broad promotion of Medicare Advantage (MA) plans by commercial insurers, AARP and CMS, 54% of Medicare eligible patients are now enrolled in MA plans. Commercial insurers can change the terms of MA plans at any time, and most recently, they have been discontinuing MA plans due to loss of profit. That leaves MA plan enrollees without coverage. MA plan enrollees might not be able to transition to traditional Medicare, because Part B supplemental insurers might deny coverage based on pre-existing conditions. MA plans also have signfinicant limitation re: choice of care proviers and facilities, which can limit access to healthcare, especially, the best specialists or facilities to meet a specific medical need.

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