What is Medicare Advantage?
A Medicare Advantage plan is Part C of Medicare. It is the program that allows Medicare beneficiaries to enroll in a private health plan to receive Medicare cover and also enjoy a few added perks. Medicare Advantage plans are offered by private insurance companies approved by Medicare. Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules fixed by Medicare.
Understanding Medicare Advantage
Traditional Medicare is a Fee for Service plan that covers many healthcare services. When you receive your healthcare service, you show you Medicare Card that is issued to you when you enroll in Medicare. This original plan pays for many health services and supplies but does not cover all your healthcare costs like co-pays and deductibles.
Medicare Advantage Plans are health plan options approved by Medicare, but offered through private health insurance companies. If you join one of these plans, you are still in Medicare, but generally get all your Medicare coverage through private companies and use the insurance that the plan provides.
The main differences between Traditional Medicare and Medicare Advantage are as follows:
• Firstly, co-pays and deductibles are lower with Medicare Advantage than with traditional Medicare.
• Medicare Advantage plans provide Medicare Part A or Hospital Insurance and Medicare Part B or Medical Insurance. However, Medicare Advantage Plans do not cover hospice care, which is covered by Original Medicare even if you are in a Medicare Advantage Plan.
• Medicare Advantage plans may also offer extra benefits such as vision, hearing, dental, preventive care services, and health and fitness programs.
• Medicare Advantage plans have Medicare Part D (Prescription Drug Coverage) built in. With Traditioanl Medicare, Part D has to be purchased separately.
• Finally, with Traditional Medicare, you can see any doctor or hospital. Many Medicare Advantage plans work with contracted providers – doctors and hospitals with whom they have worked out a long-term contract.
Different types of Medicare Advantage Plans
• Health Maintenance Organization (HMO) Plans
• Preferred Provider Organization (PPO) Plans
• Private Fee-for-Service (PFFS) Plans
• Special Needs Plans (SNP)
Other Medicare Advantage Plans
• A HMO Point of Service (HMO POS) Plan that allows you to get some services out-of-network for a higher cost.
• A Medical Savings Account (MSA) Plan combines a high deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year. You will then also have to pay out of pocket for care, until the MSA plan deductible is met, after which plan coverage begins. MSA plans may or may not have contracted providers, but MSA plans cannot restrict access to a network of doctors, facilities or suppliers.
When you enroll in a Medicare Advantage plan, you pay a monthly premium to Medicare and also a monthly premium to Medicare Advantage for the added benefits it offers.
Medicare thus offers you the option of getting your health insurance through Traditional Medicare or through private insurance with a Medicare Advantage plan. If you choose a Medicare Advantage plan, you must specifically opt to and give the authorization to receive your healthcare through the plan.
To make the right choice, compare costs and benefits carefully. Professional help is always at hand. So contact a knowledgeable insurance dealer who can explain the details and help you select the best Medicare plan.