Frequently Asked Questions On Medicare Advantage Plans

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Frequently Asked Questions On Advantage Plans
Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
However, each Medicare Advantage Plan can charge different out-of-pocket costs. Each plan can also have different rules for how you get services, like:
• Whether you need a referral to see a specialist
• If you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care
These rules can change each year.
How To Compare Medicare Advantage Plans
You want the broadest possible choice in doctors and other medical providers. More doctors and other providers accept original Medicare than private Medicare Advantage insurance. Private plans tend to be restricted to a home network, like an HMO doctor network. If you travel frequently, you may want to consider staying with original Medicare for this reason.
Medicare Advantage Plans Compared (verus) To Medigap/Supplements
With a Medicare Midigap/Supplement you will continue to be covered by original Medicare. After Medicare has paid your claims, it will automatically forward them to your Medigap plan. The Medigap plan will then pay its portion of the bill.
Medigap plans do not cover prescription drugs. Therefore you must also purchase a stand-alone Part D plan if you want drug coverage.
With a Medicare Advantage plan, you continue to pay your Part B premium as usual. You may also pay an extra premium for the plan. You are not allowed to have a Medigap and Medicare Advantage plan simultaneously.
Medicare Advantage plans typically come with deductibles and co-pays. But unlike original Medicare, they have an annual out-of-pocket limit. That means that once you have paid deductibles and co-pays that add up to the annual out-of-pocket limit, the plan will pay 100 percent of your medical bills for the rest of the year.
Medicare Advantage Plans With Zero Premium
If you can't afford or don't want to pay additional monthly premiums. Medicare Advantage plans, like other private health plans, typically charge premiums. The recent average was about $30 a month for an HMO and $32 to $63 for a PPO,
Medicare Advantage Plans Under 65
If you are under 65 but have Medicare because of a disability or other qualifying condition, after 2 years of disability you have the blanket right to buy a medicare plan guaranteed issue and a Medicare Advantage Plan.
Coverage while traveling. Many plans will only pay for emergency care when you are away from home. If you divide your time between two homes or pay extended visits to your adult children, this could pose a problem if you need something routine such as a lab test. A few plans have national networks you can use, but you can't see this information on Medicare.gov. You will have to call the plan directly to ask about it. The plan's listing on Medicare.gov has numbers for you to call.
Which Medicare Advantage Plan To Choose
The first thing to do is make sure you are seeing all the plans in your area. Does the plan have a good star rating?
What are the Co-pays, Deductibles, out of pocket limit?
Is your Hospital & doctors in the networks list of providers?
Does it offer dental and vision coverage and additional benefits?
Medicare Advantage Plans With Dental
Dental coverage through Medicare Advantage plan. You may be able to get dental coverage under some Medicare Advantage plans. Medicare Advantage plans (Medicare Part C) can include extra benefits like routine dental, routine vision, and Medicare prescription drug coverage.
Medicare Advantage Plans With Dental & Vision coverage. Many Advantage plans come with some dental and vision coverage
Medicare Advantage Plans With Silver Sneakers
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Medicare Advantage Plans With Nationwide Coverage
If you divide your time between two homes or pay extended visits to your adult children, this could pose a problem if you need something routine such as a lab test. A few plans have national networks you can use
Enrollment Periods
If you decide to buy a Medicare Advantage plan, you must enroll between Oct. 15 and Dec. 7 – the period known as open enrollment – in order for your coverage to start the first of the following year. (Original Medicare has separate enrollment periods for seniors who aren't automatically enrolled.) Because of government regulation, Medicare Advantage premiums are not influenced by age, health status or the method by which a consumer signs up (through an insurance agent, for example, or directly through an insurer).