Medicare Advantage – By now, you’ve probably seen a TV commercial (or ten) that talks about all the benefits Medicare Advantage plans offer. But before you go running to enroll in one of these plans, you’ll need to know the foundations they’re built on so you can fully understand how Medicare Advantage plans work.
Today, we’re going to review the basics of Medicare Advantage plans, how their coverage works, who is eligible, and how much they cost.
The Basics of Medicare Advantage
There are a few names for Medicare Advantage plans. You might hear them referred to as Medicare Part C or see them abbreviated as either MA or MAPD plans. If you have an MAPD plan, it means it includes prescription drug coverage. You can remember this by thinking “PD” for either “prescription drugs” or “Part D,” which is the part of Medicare that designates drug plans. So, how do Medicare Advantage plans work? The federal Medicare program allows private insurance companies to offer Part C plans to Medicare beneficiaries. Every Part C plan must meet minimum requirements, which means they have to offer all the same benefits of Original Medicare (Part A and B) other than the hospice feature, which you’ll still have under Medicare Part A. If you enroll in a Part C plan, you will get your Part A and B benefits from the private insurance company rather than the government. In return, the government pays the insurance company to provide the coverage. They do this to try to minimize government costs. In addition, most Advantage plans include extra benefits you won’t find in Original Medicare. Some include Part D prescription drug coverage, gym memberships, dental care (like cleanings, dentures, and other restorative treatment), vision exams and eyeglasses, hearing aids, meal delivery, transportation, adult daycare, and more. You might even find a Part C plan that offers a Part B premium giveback, which reduces the amount you pay for Medicare Part B. You won’t find any of those benefits in Original Medical or a Medicare supplement. You’d have to enroll in separate policies to get just a portion of those benefits, which would require additional premiums and more insurance cards to keep track of! The one you choose will have a big impact on which doctors you can see and the way your plan works.Types of Medicare Advantage Plans
One of the most important things to understand about Medicare Advantage plans is that there are actually six different kinds of plans. The one you choose will have a big impact on which doctors you can see and the way your plan works. The six kinds of Advantage plans are:- Health Maintenance Organizations (HMO)
- Preferred Provider Organizations (PPO)
- Point-of-Service Plans (HMO-POS)
- Private Fee-for-Service Plans (PFFS)
- Special Needs Plans (SNP)
- Medical Savings Account Plans (MSA)