What is Medicare Advantage?

Private insurance companies sell Medicare Part C plans, also known as Medicare Advantage. These plans offer more benefits than the Original Medicare (Medicare Part A, Medicare Part B) and combine Original Medicare coverage. These are some of the benefits offered by many medicare advise plans:

  • hospitalization
  • some home healthcare services
  • hospice care
  • doctor’s visits
  • prescription drug coverage
  • preventive care
  • dental
  • vision
  • hearing

Different types of Medicare Advantage plans

There are many Medicare Advantage plans available with medicare advice.

  • Health Maintenance Organization (HMO). HMO plans have in-network physicians and require referrals to specialists.
  • Preferred Provider Organization (PPO) PPO plans have different rates depending on whether they are in-network or outside-of-network.
  • Private Fee-for-Service (PFFS) PFFS plans offer flexibility for providers and are special payment plans.
  • Special Needs Plans (SNPs). SNPs can help reduce long-term medical expenses for chronic conditions.
  • Medical Savings Account (MSA). MSA plans combine high-deductible health plans with medical savings accounts.

Medicare Advantage

A Medicare Advantage plan may offer some advantages over original Medicare.

The customer has several options for coverage.

Original Medicare offers only two types of coverage: medical insurance and hospital insurance. The customer can purchase Medicare Part D prescription drug coverage or Medigap supplemental coverage if the customer needs additional coverage.

All the customer coverage options can be found in one plan with a Medicare Advantage plan.

Personalized plan structures

Medicare Advantage has different plans to suit the customer’s individual needs. An SNP Advantage plan, for example, can be helpful if the customer has a chronic condition.

A PPO or PFFS plan might be the best option if the customer wants provider independence. Many Medicare Advantage plans offer additional services such as hearing, vision, and dental.

Savings opportunities

Many Advantage plans do not have premiums, and many offer low or zero deductibles. Medicare Advantage has another advantage: Most plans have caps on the maximum out-of-pocket costs the customer will pay in a given plan year.

ResearchTrusted Source also shows that switching to Medicare Advantage plans can help the customer save money on lab services and medical equipment. The customer may be able to save even more on the healthcare services offered by the customer HMO network if the customer selects a Medicare HMO plan.

Coordinated medical services

Many Medicare Advantage plans offer coordinated medical care. The customer healthcare providers will actively communicate to coordinate customer care among different healthcare services and medical specialties. This will ensure the customer has a team of healthcare professionals and help avoid costly issues such as medication interactions.

One study by Trusted Source found that patients who received coordinated care had higher satisfaction ratings and positive experiences with their doctors.

Here are some tips to help the customer choose the right Medicare Advantage plan.

It can be difficult to choose the right Medicare Advantage plan for the customer. Before the customer makes a decision, there are many factors to consider.

Ask the customer self these questions when the customer is considering a Medicare Advantage plan.

What was the healthcare spending last year and the year before? This can help the customer determine the customer’s budget and how much the customer can spend on out-of-pocket and premium costs. While some plans offer $0 deductibles and premiums, others might charge hundreds.

What are the long-term healthcare requirements? Over 40% of Americans suffer from chronic conditions. It is important to think about which plan best suits the customer’s long-term health needs.

Is my current healthcare provider a Medicare-accepting provider? The customer will need to find out which Medicare plans they accept and participate in if the customer wants to keep the customer’s current healthcare provider.

What is the CMS rating of the plans the customer is considering? CMS uses a Five Star Rating System by the Centers for Medicare & Medicaid Services and medicare advise to assess the quality of Part D and Medicare Advantage plans. CMS’ star rating measures the management of chronic conditions and availability of care, member experience, complaints, customer service, and drug pricing. CMS publishes its star ratings each year.

Conclusion

Medicare Advantage and medicare advise providing many advantages over original Medicare. It includes convenient coverage, multiple plan options, and long-term savings.

It doesn’t matter if the customer chooses Original Medicare or Medicare Advantage. Before the customer decides on the customer coverage, it is important to evaluate their healthcare needs and Medicare options.