What’s Medicare Advantage?

Before changing any healthcare coverage, perhaps one of your biggest questions is, what’s Medicare Advantage? Medicare Advantage otherwise referred to as Part C, is a kind of healthcare plan that is offered by a private insurance company and highly regulated by the Federal Government and State Insurance Commissioners. Medicare Advantage is legally obligated to provide at least what Part A and Part B provide to you in coverage.

When asking what the difference between Medicare Advantage and Original Medicare is, it’s essential to concentrate on the real advantages you might receive and just how it’s different than any other Medicare plan. Medicare Advantage, as previously stated, is required to meet or exceed the benefits from both Part A and Part B Plans.

There are additional benefits a Medicare Advantage plan is able to have such as vision, dental, and even some prescription coverage (Part D), but those are not guaranteed. It depends on the actual carrier to what benefits are offered.

What are the costs of Medicare Advantage Plans?

The majority of Medicare Advantage Plans have zero premium. Please do not confuse this as Free. Even though the majority of plans are zero premium, benefits will vary from plan to plan. If your plan has a premium due it is typically less than $30 per month and if your plan charges, typically co-pays and deductibles are much lower. It is a variable that a licensed representative can help you choose the plan that is correct for you.

How do they work?

There are many types of Medicare Advantage Plans and here are the most common plans to consider. There are others available so remember, only a properly licensed individual can help you decide which program is correct for your needs. You must have Part A and Part B to qualify for a Medicare Advantage Plan.

  • Health Maintenance Organization (HMO) Plans – With these types of plans, the majority of them offer a list of providers and hospitals in their network that you can use

  • HMO Point-of-Service (HMOPOS) Plans – These are still HMOs, but with this specific type of plan, you may be eligible to see out-of-network services. Usually, this type of plan will have higher coinsurance or copayments.

  • Preferred Provider Organization (PPO) Plans – This type of plan does allow you to see other doctors and hospitals that are outside the network. Keep in mind the cost to receive healthcare outside of the network could be higher.

  • Special Needs Plans (SNPs) – With SNPs, individuals living with specific chronic conditions such as COPD or Diabetes or in a nursing home facility can receive specialized healthcare.

Medicare Advantage Plans primarily are designed to save you the consumer money out of pocket. With extra benefits such as Dental Plans, Vision Plans, and Hearing Plans, it fits very well into most individual budgets. Again, we recommend talking with a Licensed Agent to compare what your needs are.