Most people who have Medicare get their medical coverage from Original Medicare, which comprises Medicare Part A and Medicare Part B. The federal government manages Original Medicare and offers Medicare eligible recipients coverage of and access to physicians, hospitals and other healthcare providers that accept Medicare coverage.
Medicare usually pays a certain amount as a fee for each service in this fee-for-service federal healthcare plan. Do you know about Medicare Advantage Plans?
Medicare pays an agreed upon share up to certain maximum limits, leaving the person receiving Medicare to pay the balance for any services. Original Medicare does not cover everything, such as services like cosmetic surgery, long-term care, eyeglasses and hearing exams, so eligible Medicare recipients must weigh their healthcare strategy.
An increasing number of Medicare customers are choosing to get their benefits from a Medicare Advantage plan. Also known as a Medicare Part C, Medicare Advantage plans are available from private, Medicare-approved insurance companies. These plans typically bundle the coverage of Parts A and B with other services, such as dental and vision.
Take a moment to review these points to help understand the ins and outs of Medicare Advantage plans:
Original Medicare includes Parts A and B and is offered from the government program. Parts C and D (Medicare Advantage plans and prescription drug plans, respectively) are offered from private, Medicare-approved insurers, such as Anthem. That means many insurers offer Parts C and D, so these plans can vary and serve as an all-in-one alternative to Original Medicare. All healthcare providers offering Part C plans receive approval from Medicare.
Bundled plans often include Medicare Part A for hospital insurance, Medicare Part B for medical insurance and Medicare Part D for prescription drugs. Medicare Advantage plans continue to cover all Medicare services, and some offer additional coverage, such as dental, vision, hearing, gym memberships.
Medicare Advantage plans offer patients a variety of options, which include:
- Medical Savings Account (MSA): MSAs pair with high-deductible plans.
- Health Maintenance Organization (HMO): HMOs use in-network physicians and require referrals to allow patients to see specialists.
- Preferred Provider Organization (PPO): These plans focus on payment rates based on whether services are in-network or out-of-network.
- Private Fee-for-Service (PFFS): These plans offer providers with greater flexibility for payments.
- Special Needs Plans (SNP): SNPs focus on patients suffering with chronic conditions, who are facing long-term medical costs.
Choosing a Medicare Advantage Plan
If you need additional information to make the best choice in Medicare coverage, consider using a resource such as Anthem’s Medicare Advantage plan comparison chart. One key piece of information to keep in mind is that Part C plans package all the benefits of Medicare Parts A and B into one comprehensive plan to cover your medical and hospital costs. Look for plans that include Medicare Part D for prescription drug coverage, if this is now, or may become, important for you. Decide which type of plan you prefer, such as a PPO or HMO. Most of all, consider the quality of the services available to you with each plan and package.
When your prospective Medicare Advantage plan includes Part D and high-quality providers and services, you are on your way to making the best choice in Medicare options for now and the future.