10 Reasons Why a Medicare Advantage Plan Might Be Right for You with Drawbacks Considered

Jan 10, 2024 | Insurance

Medicare Advantage health plans provide similar coverage to original Medicare, with extra perks such as dental and vision coverage, gym memberships, and wellness programs added as extra bonuses. Cost, coverage, and convenience must all be carefully evaluated when choosing the appropriate Medicare Advantage plan for you. In this article, we’ll look at why the Medicare Advantage plans might be right for you.

Medicare Advantage insurance plans are approved Medicare plans offered by private companies that combine Original Medicare Part A and Part B coverage. Most plans require you to visit doctors within their network; however, Medicare Advantage often has lower out-of-pocket expenses than Original Medicare. Medicare Advantage plans typically provide their members extra services such as fitness, vision, and telehealth; their scope will differ depending on your plan.

Below Discussed Are The Top Ten Reasons Why a Medicare Advantage Plan Might Be Right for You:

1. Low Premium Payments

Medicare Advantage plans offer some of the lowest monthly premiums on the market. It helps you get health services and facilities for comparatively low premium payments. Some MA plans also provide transportation to medical appointments and remote consultation options with healthcare professionals. An advantage of many Medicare Advantage plans for seniors is that they feature caps on how much out-of-pocket expenses you’ll incur over a given plan year, offering peace of mind if budgeting is an issue.

2. Extra Coverages

Many Medicare Advantage health plans provide additional non-medical supplementary services such as rides to healthcare appointments, meals delivered directly to homes, and discounted over-the-counter medicines. Some plans even provide fitness classes, lifestyle coaching programs, and health education resources as additional perks. If you are from Texas, it’s advisable to consider the extra coverage while going for one of the right Medicare Advantage plans in Houston. 

3. Prescription Drug Coverage

Considering enrolling in a Medicare Advantage plan with prescription drug coverage? Be sure to compare it against any additional plans you might already have before deciding. Those eligible for both Medicare and Medicaid must understand how these plans interact with Medicare’s plans when selecting an Advantage plan with drug coverage. Medicare Advantage plans that offer prescription drug coverage typically feature a formulary or list of drugs covered under their plan. 

4. Medicare Coverage Abroad

Medicare does not generally cover health care services outside the US; however, certain Medicare Advantage plans and Medigap plans provide emergency room travel coverage if certain criteria are met. To determine whether a Medicare Advantage plan is right for you, review your healthcare needs and compare them with the help of a well-experienced Medicare health insurance agent.

5. Fitness Benefits

Medicare Advantage plans often offer fitness and wellness perks to encourage active living. These may include gym membership, fitness classes or programs, free health coaching sessions, and telehealth visits. There are several national programs that provide Medicare beneficiaries with free memberships at participating health clubs and fitness centers, while some Medicare Advantage plans cover it under their coverage. A plan with fitness benefits is recommended for a stress-free future.

6. Comprehensive Care

Medicare Advantage plans often work with primary care doctors and healthcare teams to coordinate and supervise the care you receive. According to two health research studies, this approach helps reduce costs while improving health outcomes. Medicare Advantage plans provide additional advantages not available with original Medicare, such as fitness classes and vision and dental coverage. It’s essential to carefully consider your options to find one with coverage suitable for you at a price within your budget. One trade off to consider is that Medicare Advantage will have prior authorization requirements for some services. Original Medicare does not have these requirements in almost all cases. Hence, this is why some people choose to get a Medigap plan in addition to original Medicare instead of Medicare Advantage. Medigap paired with original Medicare will offer beneficiaries access and control due to a lack of doctor networks and prior authorization requirements.

7. Network of Doctors and Experts

Under Medicare Advantage insurance plans, enrollees can become part of a network of doctors and specialists. Some plans offer broad networks and others not as broad – although experts are uncertain whether that equates to improved or worse care – but enrollees can get an idea of their options by perusing provider directories provided by each plan. Many Medicare Advantage plans employ a “care team” comprising nurses and physician assistants to oversee your care, improving outcomes while decreasing unnecessary tests and procedures and encouraging clear communication between providers. 

8. Cost Efficient 

Medicare Advantage plans offered by private insurers provide private plans with extra benefits such as vision, hearing, routine dental care, and wellness programs. Furthermore, most plans offer medical advice via telephone or the web and often have low premiums. Medicare Advantage plan may be helpful if it provides lifestyle coaching programs designed to help achieve goals like managing stress or quitting smoking; furthermore, it may offer reduced premiums and provide them with one card for their health care needs.

9. Card Consolidation

Card consolidation is an essential feature you may consider while selecting a well-suited Medicare Advantage plan for seniors. As you choose a Medicare Advantage plan, take into account both your healthcare needs and budget when making a selection decision. Be mindful that many Medicare Advantage plans have annual deductibles or copayments, which can add up over time; also, be wary that some plans have restricted networks that limit your choice of providers; therefore, it’s wise to review provider directories of all plans under consideration to ensure you can receive adequate health care from providers you need.

10. Financial Protection

Medicare Advantage plans provide an annual limit (out of pocket maximum) on how much health care costs they’ll cover for you during a plan year. Medigap plans often provide very strong secondary coverage in comparison to Medicare Advantage plans but they generally have higher premiums than Medicare Advantage plans. Medicare Advantage plans often offer extra perks and benefits, including dental, vision, and hearing care; gym membership through several programs in certain locations; prescription drug coverage; and transportation to medical appointments. Enrolled individuals typically must use providers within their plan network to receive the maximum benefits; therefore, it’s wise to review regularly their list of providers and hospitals in case changes need to be made.


At its core, choosing a well-suited Medicare Advantage or Medigap plan in Houston depends on how much you are willing to spend in premiums versus out-of-pocket costs. A good rule of thumb would be taking an inventory of healthcare spending from last year and then calculating an estimate for how much one can afford in premiums each year moving forward.

Your monthly premium and network size must be considered before choosing a Medicare Advantage plan. Some Medicare Advantage insurance plans utilize a coordinated care team led by a primary care physician, including healthcare professionals such as nurses and physician assistants. 

With extra benefits coming when you pay low premiums, it becomes one of the important factors when deciding on one of the top Medicare Advantage plans. When shopping around for changes, be sure you do it carefully to find one of the top Medicare Advantage or Medigap plans in Houston, and remember, it takes some research and that’s where we come into help.