Medicare Advantage
Medicare Advantage
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Medicare Part C: Medicare Advantage replaces Original Medicare (Parts A & B) while offering additional coverage of services and supports. Plans typically include prescription drugs and added healthcare features not covered by Original Medicare.
Medicare Part C: Medicare Advantage replaces Original Medicare (Parts A & B) while offering additional coverage of services and supports. Plans typically include prescription drugs and added healthcare features not covered by Original Medicare.
Medicare Advantage Plans
Medicare Advantage Plans
Choose doctors or hospitals that are in the plan's network (HMO or PPO). There are a few plans that have nationwide networks, which can be helpful if you travel frequently.
Referrals may be needed for specialists, especially for HMOs.
Prior authorization may be required for certain tests or procedures.
Many plans have a $0 premium.
Pay deductibles, copays, and coinsurance up to the Maximum Out-of-Pocket (MOOP) for the year.
Most plans include Part D: Prescription Drug Coverage
Some plans offer additional benefits.
Choosing a Medicare Advantage Plan
When choosing an MA plan, you need to consider many factors, including whether you might want an HMO or a PPO or whether you would qualify for a special needs plan based on chronic conditions or dual eligibility for Medicare and Medicaid. In addition, you should consider each of these costs and benefits:
Monthly premium - What you pay for the plan each month. As already noted, that's often $0.
Medical & drug deductibles - This is what you need to pay before insurance starts paying.
Your doctors/hospital - If you like your doctors and want to keep seeing them, you need to check the plan's Provider Directory to make sure your care team members are covered by the new plan. Recheck this every year because doctors change which insurance plans they take.
Your medications - Coverage for medications can vary greatly from carrier to carrier and pharmacy to pharmacy. You'll want to check a carrier's Formulary to make sure that all of your medications are covered. If you would like, get a plan quote that considers the full list of your medications so that you can see the monthly and yearly costs. Also consider which local pharmacy is considered Preferred; that's where you will get your medications for the lowest prices.
Maximum out-of-pocket limits (MOOP)- Each plan lists the maximum you will have to pay for for out-of-pocket cost sharing (coinsurance, copays, and deductibles). Plans usually list an in-network limit and a combined in-network/out-of-network limit.
Benefits - Medicare Advantage plans have a variety of additional benefits. What's important to you? Look for plans that include those features.
All of this might sound somewhat overwhelming! Rest assured, as your agent, I can help you understand all of your options.
If you are interested in discussing Medicare Advantage plans that fit your lifestyle, health needs, and budget, click the LEARN MORE button to get started.
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