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Research Outline
Prepared for Mit M. | Delivered May 13, 2021
Benefits of Medicare Advantage Plans
Review your project details
Goals
To understand the benefits of Medicare Advantage plans. An ideal response would include:
A cost-benefit analysis of Medicare Advantage plans [also referred to as Part C] versus Medicare Supplement plans.
The latest research and data on Medicare Advantage plans.
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Early Findings
Data Availability
The initial round of research indicates that information surrounding the benefits of Medicare Advantage plans, costs and benefits of them versus Medicare Supplement plans, and the latest research and data on Medicare Advantage plans are readily available in the public domain. All sources that we saw are recent [within 2020 to 2021, with some data from 2019].
Cost Benefit Data: Medicare Advantage Plans Versus Medicare Supplement Plans
A person
cannot have both
a Medicare Advantage and a Medicare Supplement plan.
They must make a choice
.
Medicare Part D
is included
in most Medicare Advantage plans,
along with other extra benefits.
Part D
prescription drug expenses
cannot be paid by Medicare Supplement plans.
One hundred percent of out-of-pocket costs
is paid by the
most popular
Medicare Supplement plans with Part A and Part B,
except for the Part B deductible.
Without exception
, all Medicare Advantage plans
cap a users annual
out-of-pocket costs.
Regardless of whether someone
chooses a Medicare Advantage or a Medicare Supplement plan, the person must
still continue to pay
their
Part B premium
. If the user is of the few people
who pay for Part A
, they are
compelled to continue paying
that premium as well.
General Data: Medicare Advantage Plans
"
Medicare Advantage plans
replace Original Medicare (Part A and Part B). When you buy a
Medicare Advantage plan
, the insurance company — not Medicare — provides all your health coverage. You don’t lose any benefits. In fact, most Medicare Advantage plans include extra benefits for routine vision and dental care. Nearly all include
Part D prescription drug coverage
."
Millions of Americans
depend on Medicare to meet their basic health needs. Some beneficiaries prefer Medicare Advantage to handle most or all their health needs, while others prefer Original Medicare with a supplement to cover their medical costs. In the United States, there is a total of
37,745,095 people
enrolled in original Medicare, while
23,467,152
are enrolled in Medicare Advantage plans.
Medicare Part C plans
, also known as
Medicare Advantage
, are sold by private insurance companies. They combine original Medicare (
Medicare Part A
and
Medicare Part B
) coverage and often offer additional benefits.
There are
different types of Medicare Advantage plans
to choose from, including:
One:
Health Maintenance Organization (
HMO
). HMO plans utilize in-network doctors and require referrals for specialists.
Two
: Preferred Provider Organization (
PPO
). PPO plans charge different rates based on in-network or out-of-network services.
Three
: Private Fee-for-Service (
PFFS
). PFFS plans are special payment plans that offer provider flexibility.
Four
: Special Needs Plans (
SNPs
). SNPs help with long-term medical costs for chronic conditions.
Five:
Medical Savings Account (
MSA
). MSA plans are medical savings accounts paired with high deductible health plans.
Summary Of Our Early Findings Relevant To The Goals
Our initial hour of research focused on ensuring that the research question could be answered using publicly available sources and then providing salient and relevant data surrounding some cost benefit data surrounding Medicare Advantage plans versus Medicare Supplement plans as well as some general data surrounding Medicare Advantage plans. Further research can expand upon our early findings and also explore the popularity of Medicare Advantage plans with consumers. That last part was not listed in the chat, but we did note the engagement details and saw that this research was to "validate Medicare beneficiaries' fast-growing popularity of Medicare Advantage plans(Also Known as Part C). This will be scoped for below if that is of interest.
As a reminder, Wonder only uses publicly available sources to answer all research questions. We do not do primary research, and we do not have access to paid databases or paywalled reports, but we can cite them in research for reference only [in case purchase is desired]. If that is of interest, that would clearly have to be communicated to us in any reply. However, no indication of paid resources to add value to this research was seen in the discovery phase.
It is of note that while the initial hour of research does not allow us to embed graphics and other visuals, we can certainly do that for any subsequent research projects that are selected. This will enable us to provide visual examples/graphs/charts to add color and depth to the research.
Please select one or more of the options provided in the proposed scoping section below.
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