Medicare Advantage
Some people choose to receive their Medicare coverage through private insurance companies rather than getting it directly through Medicare. The plans that allow you to do this are called Medicare Advantage plans.
If you are interested in reviewing and comparing your Medicare Advantage Prescription Drug plan options both HMO and PPO, as well as Duel Plans and Patriot Plans options, here’s what you need to know about Medicare Advantage.
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Stand-alone Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug Plan (PDP)—- A stand-alone drug plan that adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-For-Service Plans, and Medicare Medical Savings Account Plans.
Medicare Advantage Plans (Part C) and Cost Plans
• Medicare Health Maintenance Organization (HMO)— A Medicare Advantage Plan that provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. In most HMO’s, you can only get your care from doctors or hospitals in the plan’s network (except in emergencies).
• Medicare HMO Point-of-Service (HMO-POS)— A Medicare Advantage Plan that provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. HMO-POS plans may allow you to get some services out of network for a higher copayment or coinsurance.
• Medicare Preferred Provider Organization (PPO) Plan— A Medicare Advantage Plan provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. PPO’s have network doctors, providers and hospitals but you can also use out-of-network providers, usually at a higher cost.
• Medicare Special Needs Plan (SNP)— A Medicare Advantage Plan that has a benefit package designed for people with special health care needs. Examples of the specific groups served include people who have both Medicare and Medicaid, people who reside in nursing homes, and people who have certain chronic medical conditions.
• Medicare Medical Savings Account (MSA) Plan— MSA Plans combine a high deductible health plan with a bank account. The plan deposits money from Medicare into the account. You can use it to pay your medical expenses until your deductible is met.
• Medicare Cost Plan— In a Medicare Cost Plan, you can go to providers both in and out of network. If you get services outside of the plan’s network, your Medicare-covered services will be paid for under Original Medicare but you will be responsible for Medicare coinsurance and deductibles.
• Medicare Private Fee-For-Service (PFFS) Plan— A Medicare Advantage Plan in which you may go to any Medicare-approved doctor, hospital and provider that accepts the plan’s payment, terms and conditions and agrees to treat you– not all providers will. If you join a PFFS Plan that has a network, you can see any of the network providers who have agreed to always treat plan members. You will usually pay more to see out-of-network providers.
Other Health-Related Products
• Dental/Vision/Hearing Products— Plans offering additional benefits for consumers who are looking to cover needs for dental, vision, or hearing. These plans are not affiliated or connected to Medicare.
• Hospital Indemnity Products– Plans offering additional benefits; payable to consumers based upon their medical utilization; sometimes used to defray copays/coinsurance. These plans are not affiliated or connected to Medicare.
• Medicare Supplement (Medigap) Products— Insurance plans that help pay some of the out-of-pocket costs not paid by Original Medicare (Parts A and B) such as deductibles and coinsurance amounts for Medicare approved services.
Shop Medicare Advantage
Contact an insurance broker if you’re interested in finding out whether you’re eligible for a Special Needs Plan. They can also help you determine whether another type of Medicare Advantage Plan would be suitable for you.
To get in touch with a broker, call Duncan Market Insurance.