What Are Some Questions to Ask When Comparing Medicare Advantage Plans?

As you approach the age of 65, you may have heard about Medicare Advantage plans and wonder what they are. Medicare Advantage plans provide an alternative to Original Medicare, which is made up of Part A (hospital insurance) and Part B (medical insurance). They are managed by private insurers that contract with the Centers for Medicare & Medicaid Services (CMS), and offer more coverage options than Original Medicare. Let’s take a look at what you need to know about these plans.

What Is a Medicare Advantage Plans?

Medicare Advantage Plans are healthcare plans offered by private insurance companies that provide coverage through the federal government’s Medicare program. These plans usually cover more than Original Medicare, Part A and Part B, which include hospital visits, doctor appointments, preventive care, prescription drugs, and other medical services. Many times they even provide additional benefits such as vision care and dental care.

What does a Medicare Advantage plan cover?

Medicare Advantage plans each have their own unique benefits, so it’s important to check with your insurer to find out exactly which services are covered. However, most plans will cover all services that would be included in Original Medicare Parts A and B, such as hospitalization, doctor’s visits, lab tests, preventive care and some prescription drugs. Some may also include additional benefits like vision or dental coverage.

How much do they cost?

The cost of a Medicare Advantage plan depends on the type of plan that you choose as well as your location. Most plans require that you pay a premium each month in addition to any copays or coinsurance that may be required when receiving healthcare services. You will also still need to pay your Part B premium if you enroll in a Medicare Advantage plan.

Are there any restrictions?

Yes—with a Medicare Advantage plan, you must use doctors and other healthcare providers who accept assignment from the insurer for the services covered by your plan. This means that your provider agrees to accept the amount paid by your insurer as payment in full for services rendered; anything above this amount must be paid out-of-pocket by you. Additionally, if you enroll in a health maintenance organization (HMO) or preferred provider organization (PPO) plan, then there may be limits on which providers you can see based on their network status with your insurer. It’s important to check this before enrolling so there are no surprises later on. 

Conclusion:

Medicare Advantage plans provide an alternative way for individuals over 65 years old who already receive original medicare part A & B to get their medical coverage needs met while potentially getting access to additional benefits not included in Original medicare such as vision or dental coverage depending on the plan chosen. It is important to understand all of the costs involved including premiums and copays/coinsurance as well as any restrictions regarding provider networks prior to enrolling in one of these plans so that there are no surprises down the road when trying to use it for needed medical care services.

 

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