Choosing between Medicare and Medicare Advantage

If you’re over 65 or on dialysis, it’s hard to miss the many advertisements about choosing between original Medicare and the new group of plans called Medicare Advantage, sometimes referred to informally as Medicare Part C.

It’s a choice that needs to be made soon. Medicare beneficiaries can switch plans until December 7, 2020. People already on dialysis will become eligible for Medicare Advantage plans for the first time in 2021.

Some basic differences
In contrast to original Medicare, which provides consistent benefits across the country, the offerings of Medicare Advantage plans differ by location. Because Medicare Advantage plans may present advantages and disadvantages in different places, each Medicare Advantage should be evaluated individually. Medicare Advantage plans also are tied to specific health care provider networks (not to be confused with ESRD Networks).

People on dialysis
Important note for dialysis patients: If you enroll in a Medicare Advantage plan, your co-insurance balances for dialysis treatments – after the insurance pays – can exceed $500 or more per month.

Dialysis patients should talk with their provider’s financial case managers and/or their insurance advisors to make sure they enroll in the plan that best suits their individual situation.

Base decisions on individual needs
There is no one-size-fits-all decision. Each option has pros and cons, and so people should make their decision based on their own specific situation and needs, and the benefits available in specific locations.

For more information