Medicare Advantage
Part CWhat is Medicare Advantage?
As an alternative insurance option offered through private companies for those eligible for Original Medicare, Medicare Advantage Plans, known as Medicare Part C, provides the same benefits as Part A & Part B coverage. However, it offers extra benefits usually not covered by Original Medicare, such as dental, vision, hearing, housekeeping, caregiver training and counseling, and prescription drug coverage.
Some insurance plans have low to no monthly premiums; however, you will still be expected to pay a Part B premium. You will also be required to only go to doctors within the plan’s networks or risk more charges. The benefit is that there is a cap on how much you pay out of pocket each year.
Anyone enrolled in Original Medicare is eligible for a Medicare Advantage Plan, excluding those suffering from end-stage renal failure. These plans are considered exclusive from Medicare Supplement plans, and those with a Medicare Advantage Plan are not eligible for a Medicare Supplement plan. However, Medicare Advantage plans can be bundled with Medicare’s prescription drug coverage Part D plans.
Types of Medicare Advantage Plans
In most cases, insurance companies will offer four types of Medicare Part C plans. These plans are Health Maintenance Organization (HMO) Plans, Prefered Provider Organizations (PPO), Private Fee-For-Service Plans, and Special Needs Plans.
HMO plans have a specific network and will require you to choose a primary care physician who will refer you to specialists. PPO plans are more flexible with the trade-off of a higher cost. They do have a network, but out-of-network coverage can still be covered. Private Fee-For-Service plans offer the maximum flexibility but might cost more in the long run. Special Needs Plans are offered to those with chronic conditions with tailored healthcare needs.
How do you enroll?
Other times you may be able to enroll, such as during a Special Election Period. Still, it is generally recommended to register during the Initial Enrollment period or risk hefty fees.
Call an independent insurance agent to find the best options
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