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Medicare Advantage

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Medicare Advantage (Part C)

A Medicare Advantage (MA) plan is a private health insurance plan approved by Medicare. You may opt to get your Part A, B, and D benefits from a Medicare Advantage plan instead of traditional Medicare.

Low Monthly Premiums

Most Medicare Advantage plans offer $0 to low monthly premium plans.

Preferred Provider Organization (PPO)

With a Medicare Advantage PPO plan, you’ll pay less when visiting doctors, hospitals, or any health care provider when they belong to the plan’s network.

Health Maintenance Organization (HMO)

For beneficiaries with HMO plans to receive coverage for care, you must receive services from doctors in your plan’s network.

Special Needs Plans (SNP)

Special Needs Plans restrict enrollment to individuals with specific diseases or disabilities. These plans adjust doctor choices, benefits, and drug formularies to meet best the medical needs of the group they serve.

Medicare Advantage Explained

Medicare Advantage plans were created as an alternative to Original Medicare and Medigap. By joining one of these plans, you direct Medicare to pay the Advantage plan a set monthly amount for your care. In return, the plan will deliver all of your Part A & Part B services. They take on all of your medical risks.

Medicare Advantage Coverage

Many people new to Medicare will ask us about the pros and cons of Medicare Advantage plans vs Original Medicare. Much of this is in the way you access your benefits. With Original Medicare, you will have deductibles and a 20% coinsurance on Part B. You can visit any doctor or hospital that participates in Medicare, and most do.

Why Medicare Advantage

For many years, people on Medicare had only Medigap plans to choose from. While these plans have excellent coverage, not everyone can afford them. These people often opted to have only Original Medicare. When illnesses struck, they would find themselves with bills for expensive deductibles and coinsurance that they could not afford.

Joining an Advantage Plan

Part C Advantage plans have different networks, premiums, and cost-sharing. Working with an insurance agency that specializes in these plans is a great way to ensure that you consider all the variables before choosing your insurance company. Our team is very familiar with how Medicare Advantage plans work.

QUICK MEDICARE ANSWERS

Frequently asked questions about Medicare Advantage

What is a Medicare Advantage Plan?

A Medicare Advantage (MA) plan is a private health insurance plan approved by Medicare. You may opt to get your Part A, B, and D benefits from a Medicare Advantage plan instead of traditional Medicare. These Medicare private insurance plans usually have an HMO or PPO network of doctors.

What does a Medicare Advantage plan cover?

With Original Medicare, you will have deductibles and a 20% coinsurance on Part B. You can visit any doctor or hospital that participates in Medicare, and most do.

 

With an Advantage plan, you will use the plan’s network of providers, which is usually local.  You will pay co-payments when you receive healthcare services. Each plan sets its own cost-sharing. For example, you might pay a small copay for a primary care doctor visit and perhaps a higher copay to see a specialist. Likewise, some plans will charge you a daily hospital copay, and other plans might charge a flat amount for the whole stay.

What types of Medicare Advantage plans are offered?

Medicare Advantage plans include HMO, PPO, SNP, PFFS, and MSA. These plans and plan types come with a ton of information. Medicare Advantage Plans are private insurance plans that help with gaps in Medicare coverage. Although they sound like Medigap plans, don’t confuse the two as they have some notable differences.

Who qualifies for Medicare Advantage plans?

You are eligible for a Medicare Advantage plan if you have Original Medicare (Part A and Part B). Even those on Medicare under 65 due to disability may enroll. You may sign up for a Medicare Advantage policy if you live in your chosen plan’s service area.

 

When you enroll in a Medicare Advantage plan, you will pay your chosen plan’s monthly premium in addition to your Medicare Part B premium.

 

Low-income or Medicaid-eligible beneficiaries may qualify for extra help paying for premiums, deductibles, and copayments. Extra Help qualification is based on your annual income and can change anytime.

What is the difference between a Medicare Advantage plan and a Medicare Supplement plan?

Medicare supplements pay as a secondary insurance to Medicare Part A and Part B. This means they pay after Medicare first pays its portion of the bill. You stay enrolled in Original Medicare, and Medicare sends the remainder of your bills to your supplemental company. Then the supplement company pays its share according to which plan you are enrolled in. Each Medigap plan provides different benefits and the top three most popular plans are Plan F, Plan G, and Plan N.

 

Medicare Advantage plans, on the other hand, are entirely separate from Medicare. When you enroll into a Medicare Advantage policy, you get your benefits from the plan, not Medicare. You agree to use the plan’s network of providers except when you need emergency care. You’ll pay copayments for your health care treatment as you go along. Think of these plans as an alternative to Original Medicare.

To learn more about Medicare Advantage Plans contact one of our licensed agents today!

We represent 35+ carriers and are licenses in 49 states. Contact us today and see how we can increase your Medicare benefits.

Medicare Solutions services the entire country for all Medicare beneficiaries. We have been helping customers just like you since 2005.

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