Medicare was established by President Lyndon Johnson in 1965 with the goal to provide healthcare for people aged 65 and older.
Since its inception, Medicare has expanded to become a significant national health insurance program featuring a variety of plan options for members.
One of these plan options is called Medicare Advantage (MA) which offers health care benefits that Original Medicare does not. Medicare Advantage is a health insurance plan that offers traditional Medicare benefits through a private-sector health insurer.
If you will soon be eligible for Medicare or are looking for new options, Medicare Advantage may be exactly what you’re looking for. Understanding the basics of this plan could help you make your decision.
How Does Medicare Advantage Differ From Original Medicare?
Original Medicare is comprised of Parts A and B.
Part A, known as Hospital Insurance, covers the costs of hospitalization, nursing care, or home health care under certain circumstances.
Part B, known as Medical Insurance, typically covers outpatient medical bills like doctor visits.
Medicare Advantage Plans are also called Medicare Part C. This is an “all in one” alternative to Original Medicare that combines Parts A and B.
These Part C plans are offered by private Insurance companies that have a contract with Medicare. When you join a Medicare Advantage Plan, you will still have all the same rights and protections as you did under Original Medicare.
Maybe you’re already enrolled in Medicare Parts A and B. If so, it might be worth your while to consider joining this bundled plan. Medicare Advantage Plans offer perks that Original Medicare does not.
Medicare Advantage Plans usually include a fourth part—Part D. Medicare Part D provides prescription drug coverage, something that is not covered in Original Medicare. Some MA Plans even offer extra coverage like vision, hearing, and dental.
These additional benefits are why many people choose to bundle their plans under a Medicare Advantage Plan.
Keep in mind if you’re considering bundling, MA Plans operate somewhat differently that Original Medicare.
When you join a Medicare Advantage Plan, Medicare will pay a set amount for your coverage every month to the company that offers the plan.
With Original Medicare, you are free to use any doctor or hospital that accepts Medicare. With an MA Plan, you will typically need to use doctor’s that are in the plan’s network to receive your highest level of available benefits.
While this might seem like a disadvantage, Medicare Advantage Plans can actually be very cost-effective.
What Are My Costs When Using Medicare Advantage?
Individual plans, not Medicare, set the amounts you will be charged. This includes payment for premiums, deductibles, and services.
When considering your overall costs for your MA Plan, you should also pay attention to potential out-of-pocket expenses.
When you join an MA Plan, keep track of notices sent to you throughout the year. Every year, you will receive an Annual Notice of Change.
This notifies you of any alterations in coverage or costs made to your plan. Make sure you understand what you’re paying for and any changes that have been made to your plan.
To get the prescription drug benefits often bundled with an MA Plan when you have Original Medicare, you have to enroll separately in a Part D Plan. This separate enrollment is often much less expensive when bundled under Medicare Advantage.
What Types Of Medicare Advantage Plans Are Available To Me?
If you decide an MA Plan is the best idea for you, there are a variety of options you can choose from.
One of these is a Health Maintenance Organization Plan
This plan, typically referred to as an HMO, provides health care coverage from doctors and specialists within the plan’s network. The benefit of this plan is it gives you access to a wide network of doctors and hospitals.
You could also choose a Preferred Provider Organization or PPO.
This type of plan also includes a vast network of doctors and hospitals. You have the flexibility to visit specialists not on the list under certain circumstances, but this will usually cost more.
A third Medicare Advantage Plan is a Special Needs Plan.
If you have a specific health condition, an SNP might be the best option for you. This plan often covers extra days in the hospital for specific treatment.
Do You Want To Learn More About Medicare Advantage Plans?
There are a variety of Medicare Advantage Plans to choose from. Learning about your Medicare Advantage coverage choices and comparing different plans can help you understand all the options available to you.
If you’re wondering whether a Medicare Advantage Plan is right for you, talk with experienced insurance agent, Michael Suhany. He can walk you through your various options and pick a plan that works for your lifestyle. Contact Michael today.