Why should I get a Medicare advantage plan?
Many seniors get Medicare advantage plans in order to obtain increased protection for bills original Medicare does not cover. Medicare only provides basic health care coverage and therefore does not pay all your bills for health-related services. In addition to that, many other medical services such as hearing, dental, vision are not included.
These days, most retirees decide to opt for a Medicare advantage insurance plan policy over Medicare, considering that they can have more coverage and further amazing benefits. They typically offer additional benefits that can include eyeglasses, hearing and even dental. Some may furthermore include wellness and health plans. Many of the Medicare advantage insurance policies which also include original Medicare Part D which is prescription drug coverage. Advantage plans are a good alternative to basic Medicare health insurance, as your out-of-pocket expenditures will likely be reduced.
Unlike Medicare supplement, a Medicare advantage plan isn’t additional insurance. Deciding on an advantage plan policy means that you’ll reject coverage by traditional Medicare health insurance and replace it with private insurance.
The two key factors why people select Medicare Advantage plans
Medicare advantage plans present a budget friendly substitute. One of the primary selling factors that Medicare Advantage Plans have is the fairly low premium. As the federal government subsidies these types of plans, depending on the insurer, monthly premiums for MAP policies commence at as little as $0/month. A zero dollar advantage plan won’t cost you anything over what you’re currently paying for your Part B monthly premium.
Medicare advantage plans will not reject anyone based on health conditions. Every fall, from October 15 to December 7, persons eligible for Medicare are able to sign up for a Medicare Advantage Plan through a private insurance carrier.
Over 16 million seniors are currently enrolled in a MAPs or MA-PDs (Medicare advantage plans without or with prescription drug coverage). In order to select the best plan available to you, you may trust the 5-star rating, which is each year at the begin of the open enrollment period published by CMS, the Center for Medical Services, and rates all available plans on a scale of 1 to 5 stars. Plans with the highest ranking can get extra federal government subsidies, which helps insurers to keep premiums low. 5-star plans have open enrollment throughout the year.
Medicare Advantage HMO, PPO, PFFS Plans
Typically, Medicare advantage plans come as Medicare Health Maintenance Organizations (HMO) and Medicare Preferred Provider Organizations (PPO). Each plan has a network of doctors and hospitals. The insurer has negotiated the fees with the network providers, and the plan subscribers must use these health care providers in order to be covered. As long as you see an in-network medical professional, you’ll have no co-pays or co-insurance, and you won’t have to meet a deductible when getting preventive services. Most Advantage plans will not cover treatment obtained from beyond their network, unless it was an emergency. If you need a specialist who is not part of the plan’s directory, you may have to pay those charges out of pocket.
The exception are PFFS, Private Fee-for-Service plans, which may let you use any Medicare-approved health care provider. You may have a co-pay, but you are usually not required to select a primary care physician, or get a referral to see a specialist.
Although this may be too restrictive for some people, many members who are on a limited budget are satisfied with this kind of health plans, which limits the provider choice but does not compromise your medical benefits otherwise.
If you are interested in a PPO, HMO, or Private Fee For Service advantage plan, you need to check out the plans that are available in your zip code. Call a licensed professional health insurance broker who specializes in Medicare, your insurance provider or Medicare at 1-800-MEDICARE to find a Medicare advantage plan that best fits your medical needs and financial situation. If you have limited resources, you may also want to check out whether you qualify for “Extra Help” or a “Medicare Savings Program” by your state.
