Medicare Advantage Plans – Seven Questions Answered

By | December 16, 2011

What is a Medicare Advantage Plan?

Medicare Advantage plans substitute for traditional Medicare Part A and Part B. Medicare Advantage is the privatization of Medicare which means that the administration of the Medicare benefits is through private health insurance plans.

What is the Benefit of a Medicare Advantage Plan?

Traditional Medicare is a fee for service health plan. With a fee-for-service, you choose the doctor or the hospital or the clinic, and the insurance pays for part or all of the cost. A schedule laid out in the policy dictates the amount of reimbursement you receive.

With traditional Medicare, and as with any insurance, there are exclusions for services, drugs and medical supplies. There are also deductibles and co-pays which you may pay. Collectively, the exclusions, deductibles and co-pay are referred to as the coverage gap.

The advantage is that Medicare Advantage plans may provide additional coverage that traditional Medicare does not provide.

Is Medicare Advantage the same as Medicare Supplemental?

Medicare Supplement plans, otherwise known as Medigap, are plans which provide coverage in addition to traditional Medicare. Medicare Advantage plans provide coverage instead of traditional Medicare.

What types of Medicare Advantage Plans are available?

MA plans come in many variations. There are Health Maintenance Organizations, (HMO), Preferred Provider Organizations (PPO), Provider Sponsored Organizations (PSO) and Private Fee for Service Plans (PFFS).

Another possible coverage combination includes a Medical Savings Account (MSA) coupled with a high deductible insurance plan.

Not all the different types of plans may be available to you. Insurance companies bid to work in your state. The types of plans available to you are dependent upon which companies choose to do business in your state.

How much does a Medicare Advantage Plan cost?

With all health insurances, your total cost include the monthly premium, the mount of co-pay or co-insurance you pay when you use medical services along and the amount of deductible. With traditional Medicare you pay a Part B premium. If you choose a MA plan, the Part B premium is paid by the insurance company. So, the Part B premium is part of the premium you pay to the insurance company.

Your premium will also will increase if you choose coverage beyond that offered by Medicare. This can be coverage in terms of filling in the gaps of the traditional Medicare along with any added coverage such as eye and hearing exams and discounted dental work.

Do Medicare Advantage Plans cover prescription drugs?

It depends on the plan. Some Medicare Advantage plans include it as part of the MA plan. Other plans combine it with a Medicare Part D plan. Medicare Part D covers prescription drugs.

What should I consider when choosing a Medicare Advantage Plan?

There are three areas to consider when choosing a Medicare Advantage Plan. The first is thing to consider is medical. Is your doctor available in the plan? Do you have access to the specialists and treatments you need?

The second thing to consider is the costs. What is the total cost of the policy? The total cost includes premiums, co-pay and deductibles.

The third thing to consider is the additional benefits you want such as eye and hearing care.

Finally, do you want to include prescription coverage?

If you have specific questions about Medicare Advantage Plans, please visit our sponsors to find out more detailed information.