Switching to Medicare Advantage? 3 "Gotchas" You Need to Know About.

At this point, there are only a couple more weeks left in Medicare's fall open enrollment period. So if you're looking to make changes to your coverage, now's the time to get moving.

One thing you may be considering is moving off of original Medicare, dumping your Part D drug plan, and signing up for an all-in-one Medicare Advantage plan. And there are certain perks you might enjoy if you sign up for Medicare Advantage.

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Not only do Medicare Advantage plans limit your annual out-of-pocket spending, but many offer expanded services beyond what original Medicare covers. Original Medicare, for example, generally will not pay for dental care, eye exams, or hearing aids. But many Medicare Advantage plans will.

Having access to more covered benefits could help you stretch your retirement savings further. And if your retirement income is limited to mostly Social Security, cutting your healthcare costs by getting access to extra benefits could be crucial.

But before you rush to sign up for a Medicare Advantage plan, you should know that are certain "gotchas" to be aware of. Here are three traps you risk falling into.

1. The $0 premium trap

A good number of Medicare Advantage plans offer a $0 premium. But that doesn't mean your total costs will be lowered.

First, if you're on Medicare Advantage, you're still required to pay a monthly premium for Medicare Part B. Some Medicare Advantage plans do offer a Part B giveback that reduces your costs by covering a portion. But still, even with a $0 premium plan, your coverage itself may not be free.

Plus, Medicare Advantage plans have their own copays, deductibles, and coinsurance. Each plan's costs are different, but yours could easily add up.

Before you sign up for a Medicare Advantage plan, run the numbers to try to get a sense of what your total spending might amount to. Clearly, that number will hinge on the specific care you end up needing, and that's not always predictable. But review your plan's details carefully to get a basic sense of the costs you may be looking at.

2. The limited provider network trap

When you get healthcare coverage through original Medicare, you can see any doctor in the country who accepts Medicare. With Medicare Advantage, you're typically limited to a specific network of providers. Going outside your network could mean having to pay for your care on your own.

Not only might joining a Medicare Advantage plan mean giving up access to your preferred providers, but it could also mean struggling to get access to covered care if you travel outside your home ZIP code too often. If you tend to spend a lot of time in different parts of the country, you may want to stick to original Medicare.

3. The prior authorization trap

While it's true that Medicare Advantage plans tend to offer coverage beyond the scope of what original Medicare covers, it's not always easy to get access to that care. Medicare Advantage plans commonly require prior authorization for higher-cost services. And that requirement could lead to delays in care as well as denials.

The Kaiser Family Foundation reports that 99% of Medicare Advantage enrollees are subject to prior authorization. With original Medicare, there are only a limited number of services that require prior authorization. So if you're going to sign up for a Medicare Advantage plan, make sure to gear up for bottlenecks and potential stress.

You may find that switching over to a Medicare Advantage plan saves you money and gives you access to great care. But before you make that move, understand the drawbacks of enrolling in Medicare Advantage. And be sure to compare your plan choices carefully so that if you do make a switch, you end up with the plan that's right for you.

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