Medicare Advantage (Medicare Part C) is a type of health plan offered by private insurance companies that contract with Medicare to provide all or most of your original Medicare benefits.

A Medicare Advantage plan can be a good option for people who want more coverage than Original Medicare offers or want more choices regarding doctors, hospitals and other providers. Adding dental, hearing, and vision care to your plan can also be a great choice.

Medicare Advantage is a type of private insurance that offers all the coverage that Original Medicare provides (Parts A and B) plus additional benefits like dental, vision, hearing, health and fitness programs. Most also include Part D prescription drug coverage.

"People in Medicare are either in fee-for-service Medicare or they're in a Medicare Advantage plan," says Gretchen Jacobson, PhD, vice president of Medicare at The Commonwealth Fund. This foundation supports independent research on healthcare issues and makes grants to improve healthcare practice and policy.

Private insurance companies that the Centers approve for Medicare & Medicaid Services offer Medicare Advantage plans. Many types of Medicare Advantage plans include Health Maintenance Organizations (HMOs), preferred provider organizations, special needs plans (SNPs), private fee-for-service plans, and Medicare Savings Accounts.

A Medicare Advantage plan, or Part C or MA, is an alternative to Original Medicare (Parts A and B). These plans offer a combination of hospital and medical coverage and some extra benefits not included in Original Medicare.

They typically manage care and have networks of contracted healthcare providers. They offer more provider freedom than Original Medicare but may also have higher premiums and uncovered copays.

These advantages can be worth considering, especially if you want more predictability and value in your health care. MA plans, we offer a wide range of benefits that support your overall well-being, including telehealth services, mental health and loneliness assistance, connecting you to healthy meal delivery and grocery options, supporting vaccination efforts and managing your care needs.

Unlike a Medigap policy, which can have ever-increasing premiums based on age, a MA plan has a fixed annual limit on out-of-pocket costs, called the maximum out-of-pocket limit, or MOOP. Once you reach the limit, the MA plan pays 100% of covered services.

The costs of a Medicare Advantage plan vary greatly, depending on the type of plan, the copays and deductibles, drug coverage or lack of it, and extra benefits. People with limited income and resources can get help to pay for their premiums and out-of-pocket costs through Medicaid or Medicare Savings Programs. Typically, plans have a maximum out-of-pocket limit for Part A and B services. Generally, this limit is much higher than what Original Medicare provides.

Medicare Advantage Plans also use "rebate" dollars to cover some non-Medicare supplemental benefits, including over-the-counter drug coverage (which is usually a percentage of the prescription price) and transportation to doctor visits, meal benefits, and adult day care. The federal government pays these rebates to private plans, which can charge their enrollee additional premiums for the extra benefits.

Average MA-PD premiums have decreased since 2015, and a growing share of plans are bidding below the local benchmark, which allows them to offer coverage without charging an extra premium. The rise in rebates to plans has contributed to a 24% increase in the number of supplemental benefits that Medicare Advantage plans can offer.

A Medicare Supplement plan, or Medigap, can help pay for some out-of-pocket expenses that Original Medicare doesn’t cover. These costs can include deductibles, copayments and coinsurance. In addition, many Medigap plans offer additional supplemental benefits, like dental and vision care. Some also offer hearing aids, gym memberships and prescription drug coverage.

Private insurance companies licensed by TDI sell Medicare Supplement insurance. Each policy must provide standardized benefits nationally, but premiums can vary from company to company.

You can buy a Medicare Supplement plan during your one-time, six-month open enrollment period, which starts the first month you have Medicare Part B and are 65 or older. You can’t be denied a plan based on your health history or condition during this time.

Go Back

Post a Comment
Created using the new Bravenet Siteblocks builder. (Report Abuse)