Author: Carmelo DeFranco
Date: 06/16/2022
Reading Time: 3 minutes

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What is Medicare Advantage Plan?

Medicare Advantage Plan is another way you can get your Medicare Part A and Part B coverage. The Medicare Advantage Plan, also known as Medicare Part C, is provided by Medicare-approved private companies. These private insurance companies must follow the rules and guidelines set by Medicare. Remember, if you enroll in Medicare Part C, you will get most of your Part A and Part B coverage from your Medicare Advantage Plan/Part C instead of your original Medicare.

Medicare Part A covers:

• Home health & hospice care services
• Care in a skilled nursing facility
• Hospital care

Medicare Part B covers:

• Laboratory tests
• Doctor visits
• Screening
• Ambulance transportation
• Medical equipment
• Outpatient services

What coverage does Medicare Part C provide?

The Medicare Advantage Plan offers numerous benefits, including special fitness programs, vision, hearing, and dental services. Medicare Part C can also provide other benefits such as OTC drugs, transportation to a doctor, and other services that promote your health and wellness. Medicare Part C can also tailor its benefit packages to help those with underlying medical conditions. These packages are tailored to benefit enrollees who have specific health conditions. Therefore, before enrolling in these plans, carefully review them to determine if you might qualify, the benefit it offers, and if there are any limitations. 

Costs Associated with Medicare Advantage Plans

The cost of the Medicare Advantage Plan depends on a wide range of factors. Firstly, you must enroll in Medicare Part A and Part B if you want to purchase Medicare Advantage Plan. That’s the first requirement you are required to fulfill. After enrolling in Medicare Parts A and B, you need to pay a monthly premium. Their monthly premium varies with Medicare Advantage Plans, but it can start from as low as $0. Other costs associated with Medicare Advantage Plan include:

• Annual deductible
• Coinsurance, i.e., the percentage of service you should pay out of your pocket after meeting a deductible
• Copayments, i.e., the money you owe a doctor after a visit or prescription drug refills
• Out of pocket maximum, i.e., refers to the yearly limit you must pay for your health care costs

How do Medicare Advantage Plans Work?

There are different forms of Medicare Advantage Plans, with each plan choosing what additional coverage to offer. The most common Medicare Advantage Plans include Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans. Since these plans are different, they are available with different rules and restrictions, benefits, coverages, and providers you can access. 

What are the differences between PPOs and HMOs?

• HMO plan – where you need to choose a primary health care provider. With this health plan, you are required to receive all your non-emergency care from providers within the plan’s network.

• PPO plan – with a PPO plan, you can visit any health care provider who accepts your plan. However, you can pay less money if you see a health care provider within your network. 

If you are trying to choose between the original Medicare and Medicare Advantage Plan, you need to research well. Medicare Advantage Plan is the best option if:

• You want different types of healthcare insurance plan options
• You want your prescription drug coverage and health coverage under one plan
• You need annual dental, vision, and hearing coverage
• You do not travel or seek medical attention out of state
• You would greatly profit from out of pocket maximum

With Medicare Advantage Plan, you can customize your health insurance to suit your health needs and lifestyle. This means that you can choose the benefits you need depending on your health condition.

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