Medicare Advantage
Medicare Advantage
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Medicare Advantage, also known as Part C, replaces Original Medicare (Parts A & B) while offering coverage of Medicare services and supports. Plans typically include prescription drugs and added healthcare features not covered by Original Medicare.
Comparison
Original Medicare + Medigap plan
Original Medicare + Medigap plan
Choose any doctor or hospital that takes Medicare anywhere in the US
Referrals not needed (in most cases).
Pay the Part B premium
Pay the plan premium
Medicare Advantage
Medicare Advantage
Choose doctors or hospitals that are in the plan's network (HMO or PPO). There are also a few Medicare Advantage carriers with plans that have nationwide networks, a benefit to frequent travelers or 'snow birds.'
Referrals may be needed for specialists, especially for HMOs.
Pay the Part B premium
Pay the plan premium (often $0)
Pay deductibles, copays, and coinsurance up to the Maximum Out-of-Pocket (MOOP) for the year.
Medicare Advantage vs Medigap
Medicare Advantage vs Medigap
Many wonder how Coordinated Care (HMO or PPO) Medicare Advantage plans compare to Medicare Supplement (Medigap) plans. The following table summarizes the key points. As your agent, I can answer questions and explain these choices more fully as they relate to your unique interests, health needs, and budget.
Many wonder how Coordinated Care (HMO or PPO) Medicare Advantage plans compare to Medicare Supplement (Medigap) plans. The following table summarizes the key points. As your agent, I can answer questions and explain these choices more fully as they relate to your unique interests, health needs, and budget.
Choosing a Medicare Advantage Plan
When choosing an MA plan, you need to consider many factors, including whether you might want a Coordinated Care plan (an HMO or a PPO), a Private-Fee-For-Service (PFFS) plan, or a Medicare Savings Account (MSA), depending on what's available in your area. In addition, you should consider each of these costs and benefits:
Monthly premium - What you pay for the plan each month.
Medical & drug deductibles - This is what you need to pay before insurance starts paying.
Your doctors/hospital - If you like your doctor(s) and want to keep them, you need to check the plan's Provider Directory to make sure they are in-network for the new plan.
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 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.
Out-of-pocket limits - 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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