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Medicare Advantage Plans
Medicare Advantage Plans
A Medicare Advantage Plan provides a solution to getting your Medicare Part A and Part B coverage. Medicare Advantage Plans, often described as “Part C” or “MA” Plans, are offered by Medicare-approved private companies that must adhere to rules set by Medicare.
There are several types of Medicare Advantage Plans. Each of these Medicare Advantage Plan types have specific rules regarding how you get your Medicare-covered Part A and B services along with any supplemental benefits your plan covers.
Generally, you can join an Medicare Advantage Plan if you have Medicare Parts A and B.
If you go with a Medicare Advantage Plan, you still have Medicare. Much of your Part A and Part B coverage may be satisfied by your Medicare Advantage Plan and not Original Medicare.
Medicare Advantage Plans may have different: (Network of providers, Coverage rules, Premiums (in addition to the Part B premium). Cost-sharing for covered services)).
Even plans of the same type offered by different companies may have different rules, so you should always check with a plan directly to find out how its coverage works.
Although some Medicare Advantage Plans offer prescription drug coverage (Part D), people with Original Medicare who want Part D coverage can enroll in a stand-alone Part D plan.
Medicare Advantage Plans cover Medicare services
Generally, Medicare Advantage Plans provide all of your Part A and Part B benefits. Plans generally cover almost all medically necessary services Original Medicare covers. Generally, clinical trials and hospice services are not included in Medicare Advantage Plan benefits. Original Medicare may help cover some of your costs for hospice care and clinical research studies if you’re in a Medicare Advantage Plan.
A Medicare Advantage Plan may choose not to cover costs of services that are not medically necessary under Medicare. If there is any question as to whether a service is covered, check with your provider before you get the service.
Things that Original Medicare doesn’t cover might be covered with a Medicare Advantage Plan such as fitness programs and some hearing, dental (routine check ups, cleanings) and vision services.
Some plans may provide coverage for things like over-the-counter drugs that Part D doesn’t cover or perhaps services that support your health and wellness. Before you enroll in a Medicare Advantage Plan, review the benefits it offers, determine if you might qualify and explore limitations.
Most Medicare Advantage Plans include Medicare drug coverage (Part D). You usually pay a monthly premium for the Medicare Advantage Plan in addition to you Part B premium. You may have to pay all the costs of a service that the plan determines is not medically necessary.
Types of Medicare Advantage Plans
HMO
Health Maintenance
Organization Plans
PPO
Preferred Provider
Organization Plans
PFFS
Private
Fee-For-Service Plans
SNP
Special Needs Plans
MSA
Medicare Medical
Savings Account