Medicare Advantage Plans are government-offered private insurance plans provided to senior citizens age 50 or over. Original Medicare is a government-run insurance program. Medicare Part A is health insurance, and Medicare Part B isn’t health insurance. Medicare Advantage Plans offer the same basic coverage as original Medicare does but also can be purchased by private health insurance providers. Advantage Plans are not subject to Medicare Parts A or B.
Some people believe that Medicare advantages are nothing more than a fancy billing statement for using the internet to order supplements and drugs. This could not be further from the truth. Advantage Plans work just like health care plans offered through the original Medicare program do. They are used to supplement Medicare payments to cover the cost of medically necessary services. In essence, Medicare pays medicare benefits for you, providing additional coverage at little or no extra charge.
To compare Medicare Advantage plans it is important to understand how they work. Once you have determined which specific plans you want to participate in, you must enroll in the plan. Your Medicare representative will provide you with instructions on how to enroll in your specific plan.
Usually, you must enroll in both Medicare Part A and Part B within a certain timeframe, say 30 days each year. In general, if you are enrolled in Medicare Part A, your beneficiaries enrolled in the plan will also be enrolled in Part A, and Medicare Part B will pay the Medicare Advantage Plan provider.
There are several types of Medicare Advantage Plans available, based on the service selected by the individual. Each plan offers different features and benefits to different people, so it’s important to understand exactly what your Medicare representative is telling you when he or she gives you enrollment information.
The general categories of coverage provided are outpatient hospital expenses, inpatient care, nursing home costs, emergency services, adult daycare, prescription drugs, durable medical equipment, imaging equipment, hearing aids, occupational therapy, travel insurance, and Medicare supplements. Each plan may contain extra features specific to its particular Medicare Advantage Participants.
One of the most common ways that people enroll in Medicare is through premium and risk-managed private health plans. Premiums are usually set by the health care provider and may be updated periodically. Certain medical emergencies, Medicare benefits that are considered “core benefits,” and certain taxes are deductible for plan enrollees. Participating in Medicare does not require a vote of confidence, but there are annual enrollment audits.
Private health care plans are voluntary, meaning that Medicare beneficiaries can choose not to enroll in the program. In addition, Medicare Advantage plans are not mandatory Medicaid programs, so it’s up to the individual how much he or she wants to pay in premiums. Because of this, enrollees can shop around and find the most affordable plan with the best coverage for them.
Although these plans offer many benefits, enrollees should also know what services they will need to be covered, the copays and deductibles that they will have to pay, and the exceptions that are allowed. Medicare Advantage plans were designed to make it easier for seniors to meet their healthcare needs without going bankrupt. If you’re considering a change to Medicare, now is the time to explore the options available to you.