If you are reading this, you are likely looking to find more information about Medicare Advantage. In this article, we will explain what a Medicare Advantage plan does for you, the reasons you might consider enrolling in one, and the benefits of having one. Keep in mind that Medicare Advantage plans have a lot of different functions and working parts. In this segment, we will summarize the idea behind a Medicare Advantage plan and will go into further detail in later articles.
What is a Medicare Advantage Plan?
Medicare Advantage plans are Medicare-approved private health insurance plans. The plans are usually offered by private insurance companies but are regulated by The Centers for Medicare and Medicaid Services (CMS). Medicare Advantage plans can be added to benefit individuals that are enrolled in Medicare parts A and B. The reason a Medicare-eligible individual might consider a Medicare Advantage plan is because of what is missing from Original Medicare parts A and B’s benefits. These plans provide additional benefits, and operate and cost a differently than your standard Medicare A and B plan.
The benefits of an Advantage plan can be a much richer coverage and include coverage that Original Medicare A and B do not offer. These plans have an all-in-one type of coverage and provide incredible benefits. The programs are required to include all of the coverage’s provided by Original Medicare parts A and B. They often have many more benefits offered than what is available through Original Medicare. Thus, a Medicare Advantage plan is a great option to consider when enrolling in a Medicare plan. Many Medicare enrollees across America choose this type of coverage every year, for their coverage and medical needs. Read on to learn more about Advantage plans, how they work, and why they’re so beneficial to many Americans every year.
How Medicare Advantage Plans Work
As mentioned prior, Advantage plans are private health insurance plans for those enrolled in Medicare parts A and B. The beneficiaries decide to enroll in one of these plans and will need to register via an application process. If the program has a monthly premium (which many do not have any monthly cost), pay a monthly premium to the insurance company offering the plan. Once the plan begins, the enrollee will receive coverage for Medicare Parts A and B services, through the insurance company. This means that any care that is needed by the enrollee, that’s covered coverage through the plan, is billed through the insurance plan.
What is the main reason a person should consider enrolling in a Medicare Advantage plan? An Advantage all-in-one type of package is the reason most people choose this coverage. As you are probably aware, Original Medicare has many cost-sharing responsibilities that are the Medicare recipient’s responsibility. These cost-sharing requirements have no limit to the maximum out-of-pocket you would be responsible for paying in the event of a Medicare-covered medical event. Also, Original Medicare does not offer essential coverage, such as dental, vision, hearing, and prescription drug coverage.
With a Medicare Advantage all-in-one type of policy, there is a maximum out-of-pocket limit. That would be your responsibility, so it is easier to set a dependable medical spending budget during your Medicare years. Remember, most people get Medicare in their retirement years, which are years that their income is typically not as high because they are retired. So having a dependable spending budget is very important during these golden years.
Many Medicare Advantage plans also offer, included with the benefits of the all-in-one plans, coverage such as dental, hearing, vision, and prescription drug coverage (in some instances). Some plans offer additional benefits like fitness packages, over the counter drug benefits, rides to and from your doctor’s office, and other benefits according to plan specifics.
Medicare Advantage plans usually have a network of doctors and hospitals. This means you might have to see certain doctors and visit individual hospitals within the plan’s network to receive care. If the plan is a PPO type of plan, the plan will have a network of doctors and hospitals, but not require you to stay within the system. The plan will offer the coverage at the cost-sharing scenarios based on the plan chosen. It will usually offer a lower cost-sharing price if the covered individual stays within the plan’s network. An HMO type of policy will have a network, and except in an emergency will require the covered individual to remain within the network to receive care.
Medicare Advantage plans will probably save you money as well as give you more coverage than Original Medicare. The plans are required to limit the out-of-pocket costs and have a maximum out-of-pocket limit built into their plans. The out-of-pocket cost-sharing is typically lower than Original Medicare, and the coverage offered is usually more than what is provided through Medicare A and B. For this reason, an Advantage policy should be an option seriously considered when trying to obtain coverage for your Medicare.
The Basic Benefits of Medicare Advantage
As mentioned earlier, Medicare Advantage plans cover additional benefits such as vision, dental, and hearing. Some include Medicare Part D prescription drug benefits and other coverage that the policy might have built into the specific plan. Medicare Advantage plans also take away the unknown 20% on most coverage, and then instead give you specific deductibles, coinsurance, and co-pays for each service that is performed. These various coverages help reduce the possible out-of-pocket expenses that would be required through Original Medicare parts A and B, or that another member might have as an out-of-pocket responsibility according to their Medicare provider’s services. Typically, the costs are much less than a person would pay with an Original Medicare plan.
Why Medicare Advantage?
Medicare Advantage plans are an excellent choice to consider when picking a Medicare plan. Because of their variety of benefits, and their selection of all-in-one type of programs, it is much easier to understand your potential out-of-pocket expenses, and gives you the coverage’s that you might need according to plan specifics. Medicare Advantage companies in your service area might have several different plans for you to sign up for, all depending on your different medical needs and where you currently live. It is best to speak with a licensed agent to understand how Advantage plans might suit your individual needs best.
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