Medicare Advantage (MA) is also known as Medicare Part C. This type of coverage is offered by private health insurance companies to those who are eligible for Medicare.
Medicare Advantage plans are an alternative to Original Medicare (Parts A and B). These types of plans include Part A, B, and D coverage, coming together into what’s known as an MA.
Types of Medicare Advantage Plans
There are different types of Medicare Advantage plans such as HMO, PPO, MSA, PFFS, SNP and HMO POS plans. If all these abbreviations make your head spin, don’t worry. That’s why Largent Insurance is here for you. And of course, each of these plans include different types of benefits. For example:
HMOs and PPOs
These are two of the most common ones which include networks and typically include drug coverage. HMOs (Health Maintenance Organizations) are network-based plans that only allow you to visit doctors in a specific network unless it’s an emergency.
PPOs (Preferred Provider Organizations) allow you to see in-network doctors, but on the other hand allow you to visit doctors out-of-network for a higher cost.
MSAs
MSAs (Medical Savings Account) don’t have networks. They are high deductible plans which include a savings account. This type of plan allows you to deposit money into an account each year and then use the money for approved medical expenses at any time during the year. Because these plans don’t include drug coverage you will need to purchase a separate prescription drug plan on your own.
PFFS, SNP and POS
PFFs (Private Fee-for-Service) plans allow you to visit any doctor that accepts the plans payment terms. The plan has a set amount it will pay and how much you will pay for certain services.
SNPs (Special Needs Plans) are health care plans for certain groups of people such as those are on Medicare and Medicaid, living in a nursing home or those who have chronic health conditions.
POS (Point of Service) plans allow you to use out of network services at higher cost for copays and coinsurance.
Medicare Advantage Extra Benefits
When you hear the term “extra benefits”, these typically include benefits such as vision, hearing, dental, fitness, and more. These are definitely nice benefits above and beyond Original Medicare, but it’s important to make sure you look at the overall benefits before selecting a plan.
Features of a Medicare Advantage Plan
- A large percentage of plans offer prescription drug coverage
- Zero premium or low premium plans are offered
- Out of Pocket Maximums for all plans
- There are out of pocket expenses such as: deductibles, copays and coinsurance
- You have to pay the standard Part B premium ($144.60 in 2020)
- Plans are subject to change each year unlike Medicare Supplement plans
Location is Important
- Medicare plans varies by county
- Typically, there are more plans offered in larger metropolitan areas as compared to rural areas
- You can only enroll in a plan in your service area
How Much to Medicare Advantage Plans Cost?
A large percentage of Medicare Advantage plans have no premiums, but that varies by county. Medicare Advantage plans are also known as “pay as you go” plans, meaning you pay deductibles, copays, and coinsurance as you need various services. Of course, these are paid until you reach your out-of-pocket max.
How Do You know if a Medicare Advantage Plan is Right for You?
If you answer yes to any of the following questions you may be a good fit for MA plans.
- You are fairly healthy and don’t visit doctors often
- You have limited financial resources
- Lower premiums is your preference
- You typically don’t travel a lot
- You live in a larger metropolitan area where you have more MA plans available
If you’re still not sure whether a Medicare Advantage plan is the best fit for you, please don’t hesitate to call us for a FREE consultation.
Marc Largent has been helping seniors in Greensboro, Winston Salem, and surrounding areas of the Triad navigate the Medicare system since 2015. He enjoys educating and helping his clients understand their Medicare options in a very simplistic way. Largent Insurance’s top priority is customer care and treating others like family.
