Medicare Advantage Plans are health plans that are approved by Medicare and are run by private insurance companies. Medicare pays money to private insurance companies to provide your healthcare services. These plans are sometimes referred to as “Medicare Replacement” policies and are part of Part C of Medicare.
When you enroll in a Medicare Advantage (MA) or Medicare Advantage with Prescription Drugs (MAPD), you are still enrolled in Medicare, but the plan provides all of your Part A (hospital) and Part B (medical) coverage and must cover all services that Medicare covers.
Almost all Medicare Advantage plans include Part D (prescription drug coverage) and some plans even pay offer extra benefits like dental and vision.
You Can Enroll in a Specific Medicare Advantage Plan If…
- You live in the plan’s service area
- You have Medicare Part A and Part B
- You do not have end-stage Renal Disease (ESRD)
We find that Medicare Advantage plans are a good option for people on disability who cannot get a Medicare supplement because it will limit out of pocket costs. Medicare Advantage plans may not be the best fit however for everyone. We can help you determine if these plans are the right fit for you.
How Medicare Advantage Plans Differ from Original Medicare
Yes, Medicare Advantage plans are different from the original Medicare program. How so?
- You must still pay your Part B premium
- You do not use your Medicare card. Instead, you use your plan’s ID card.
- Generally, all services have a copay (primary care doctor visit, specialist visit, x-ray, blood work, in-patient hospital stay, physical therapy).
- You do not need and should not buy a Medicare Supplement if you choose a Medicare Advantage Plan.
- There may be extra benefits such as some dental, vision and hearing coverage.
- Plans have an annual out of pocket maximum which can help limit your costs.
- All these plans have a network of doctors. There are two types of networks: HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization).
- With an HMO, you can only see doctors in the network. If you go out-of-network, you pay 100%.
- With a PPO, you can go to doctors in or out of the network. It you go out-of-network, you will pay a higher copay.
Make Sure to Do An Annual Review with Imagine Insurance Advisors
The only time you can change your Medicare Advantage plan is during the annual enrollment period (October 15 to December 7) unless you have a Special Enrollment Period (SEP) event.
We highly recommend evaluating your coverage at least every two years as the networks of doctors can change as do the formulary of drugs. Imagine Insurance Advisors offers a complementary review of your plan.
We look up your doctors to make sure they are still in your selected network and look up your medications to ensure they are on the formulary. We find that plans change every year just like Part D Drug Plans. We are appointed with all the carriers in our area to ensure you get an unbiased recommendation. Contact us to get your free review, we are here to help!