If you are one of the more than 65,000,000 Americans who are enrolled in Medicare, it’s important for you to understand how Medicare Advantage plans work. Medicare Advantage plans offer valuable benefits to Medicare enrollees, and almost half of those on Medicare opt for a Medicare Advantage plan. You need to do your research and learn about Medicare advantage plans if you are in the process of enrolling in Medicare or if you want to increase the coverage you get as a Medicare enrollee.
What Medicare Advantage Plans Are
A Medicare Advantage plan builds on the coverage offered by Medicare parts A and B by including Medicare part C coverage. Medicare Advantage plans are provided by private insurers rather than by Medicare alone. When you enroll in a Medicare Advantage plan, you’ll get part A and B coverage on your Medicare Advantage plan. Medicare will pay a fixed amount toward your parts A and B coverage with the private insurance provider offering you your part C coverage. Insurance providers who offer Medicare Advantage plans must follow rules set down by Medicare and give Medicare Advantage policyholders the same rights that they enjoy under original Medicare. Additionally, these policyholders get benefits like coverage for prescription drugs, dental care, and vision care. Medicare Advantage plans can also offer coverage for hearing services.
Medicare Advantage plans generally include Medicare part D, which refers to prescription drug coverage. A lot of Medicare Advantage plans will also cover benefits like gym memberships. It’s important for Medicare enrollees to understand that Medicare Advantage plans can differ widely among different providers since they are provided by private insurers companies.
Who Benefits from Medicare Advantage Plans
Almost anyone who is dependent on Medicare for health insurance will benefit from investing in a Medicare Advantage plan. If you are just relying on original Medicare alone- meaning only part A and part B- you won’t be covered for prescription drugs. You also won’t be covered for dental care and eye care.
If you routinely need to fill prescriptions because of a chronic condition such as diabetes, it’s definitely important for you to have prescription drug coverage through a Medicare Advantage plan. It’s also important to invest in a Medicare Advantage plan if you don’t have dental care through any other insurance plan.
While you should always do your research to figure out the best Medicare coverage option for your unique situation, it’s probably best to get a Medicare Advantage plan rather than relying on parts A and B Medicare coverage alone.
How Medicare Advantage Plans Differ from Original Medicare
Medicare Advantage plans are distinct from original Medicare because they include prescription drug coverage, dental coverage, and eye care coverage. Medicare Advantage plans are distinct from Medicare parts A and B.
Medicare part A covers inpatient care. Medicare part A also covers home health care and hospice care. On the other hand, Medicare part B is designed to cover a patient’s health care needs when it comes to outpatient procedures and treatments. This means that you can’t rely on Medicare part A or part B when you need to fill a prescription.
Medicare parts A and B are provided by the US Department of Health and Human Services. These types of Medicare are not provided by private insurance companies for consumers who are not on a Medicare Advantage plan. This is another key difference between original Medicare plans and Medicare Advantage plans.
Types of Medicare Advantage Plans That Are Available
There are numerous types of Medicare Advantage plans available. A Medicare Advantage plan can be set up as either an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) plan. Medicare plans are also available as PFFS (Private Fee-for-Service- plans.
A Medicare Advantage plan that’s set up as an HMO plan is ideal for consumers who don’t mind being restricted to a certain network when deciding where they will go for medical treatment. While a PPO plan does offer lower cost healthcare if the policyholder goes to a health care provider within a certain network, PPO plans do give policyholders more freedom to seek healthcare outside of the plan’s network.
Other Medicare Advantage plan types that are available include SNPs (Special Needs Plans) and HMO Point-of-Service plans.
You should now have all the basic information you need to make a decision on whether Medicare Advantage coverage is right for you. You can get more information on Medicare Advantage plans by visiting Medicare.gov or by getting in touch with Medicare Advantage providers in your area. Making an informed decision about Medicare Advantage coverage helps ensure that you have the coverage you require to get needed medical care paid for in an affordable way. There are many Medicare Advantage providers that you can consider. Find a Medicare Advantage plan that is tailored to your unique medical needs and health care preferences.
