Medicare Advantage Explained

What Is Medicare Advantage?

Medicare Advantage Plans sometimes called "Part C" or "MA Plans" is a type of coverage you can get that is administered by a private insurer. These plans will sometimes give you additional benefits like dental, vision and hearing coverage. These plans sometimes will also cover your prescription drug coverage. Each Medicare Advantage Plan are guaranteed acceptance with only one qualifying health question.  Those consumers with ESRD or End State Renal Failure will not qualify for a Medicare Advantage plan in most cases. Medicare Advantage plans sometimes offer other benefits like Over the Counter drug reimbursement or a gym membership AKA Silver & Fit or Silver Sneakers at no additional cost.

Medicare Advantage Cost ?

Medicare Advantage plans generally have a Zero or LOW Cost. For Individuals with a Low Income or have extra help from medicaid  can take advantage of additional benefits. There is no catch and that's the hardest thing to explain to a consumer. You're probably thinking "How Am I able to get all these benefits like dental, vision and hearing all for zero or low cost"? The truth is Medicare pays a fixed amount for your care each month to companies offering these type of Medicare Advantage Plan. Each plan has a cap or Max out of pocket that you would be responsible in an event of a hospitalization or catastrophic event. Medicare Advantage plans also are specific to a county and state. If you move out of state you will need to change plans.

Can I Keep My Doctor?

 The Medicare Advantage companies have specific rules to follow but must give you at least the same benefits as original medicare. These types of Medicare Advantage Plans also use Network to help reduce the cost to offer you more benefits.  The most common Networks are  HMO, PPO, POS. You will be required to see your primary care doctor to coordinate your benefits on an HMO plans and PPO plans will give you the most flexibility. In case of an emergency you will always be in network and don't have to worry about that while your on the way to the hospital. You can check the network doctor list and the plan prescription formulary on the Medicare Advantage plan before you enroll to save yourself the headache later.