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Medicare Advantage Maximum Out-of-Pocket Costs

Senior Holding Yellow Piggy BankMedicare Advantage maximum out-of-pocket limit a benefit

When comparing Medicare Advantage Plan benefits, don’t overlook what may be the single biggest benefit of all – the limit  Medicare Advantage maximum annual out-of-pocket costs.

It’s true that Medicare Advantage Plans include many cost saving benefits but the single benefit that could save you the most is the limit on your out-of- pocket expenses.

The fact is, original Medicare does not offer the beneficiary the safety net of a maximum amount out-of-pocket expenses like a Medicare Advantage Plan.

Original Medicare requires a  hospital deductible and on going costs for extended stays. For outpatient services you are required to pay 20% of costs for covered services… but 20% of what?

With the cost of medical care rising faster than other segments of the economy you could easily find yourself with thousands of dollars in medical bills.

Compare Medicare Advantage Plans at the Medicare website

When analyzing the list of available Medicare Advantage Plans you will find:

  • Plan name
  • Monthly premium
  • Part D premium
  • Part D deductible
  • Medicare Star rating

You can also see the maximum amount you could be required to pay. The Medicare Advantage maximum-out-of-pocket amount for 2012 is $4700.

Tips for Finding Affordable Medicare Plans

It’s up to you to do your homework and evaluate the Medicare Advantage Plans that you have an interest in by digging a little deeper than just researching premium amounts and doctor co-pays. Out-of-pocket maximums can vary widely.

Don’t overlook this important feature of Medicare Advantage Plans. You may think that you have the best plan because of the premium amount or low co-pay amount but if your out-of-pocket maximum is much higher than other plans, you may find yourself with a greater expense in the long run.

Compare plans online to find features that will suit your needs.

No comments

  1. I currently see an allergist, Dr. Bensch from Stockton, will I be able to continue seeing specialist of my choice on an advantge plan.

  2. Margaret, That depends on which type of Advantage plan you enroll in. If you join a HMO, you will not normally be able to go out of network, but that’s not to say that Dr. Bensch is not a network provider. If you join a PPO or a HMO-POS plan you will be able to choose your own provider but will generally pay more to go out-of-network. A PFFS plan will allow you to choose any provider that accepts the plans terms and conditions. Keep in mind that with this type of plan, the provider can make the decision to accept or not accept the plan on a visit-by-visit basis.

  3. A visit by visit basis! This is Bullshit! all government plans are bullshit when it comes to insurance!

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