Medicare Advantage is a plan of Medicare that private insurers offer, and they tend to have an agreement with the program. Also called Medicare Part C, Medicare Advantage Plans provide outpatient, prescription, and hospital coverage. Hence, they supplant benefits that patients receive under Medicare Part A, Part B, and Part D. If a person joins a Medicare Advantage Plan, he continues to enjoy Medicare. Again, he pays the premiums for Medicare Part B, too, besides the charge that the plan charges. Commonly, MA plans have a modest out-of-pocket choice compared to original Medicare, and they offer some extra benefits, too. MA plans need members to get care from their network providers and referrals when they want to see specialists.
Choosing the best MA plan
You can take your pick from various kinds of MA plans, and some of them are:
- PPO – Preferred Provider Organization plans have distinct rates based on either out-of-network or in-network services.
- HMO – Health Maintenance Organization plans use in-network physicians, and to avail of them, patients need referrals from specialists.
- SNPs – Special Needs Plans assist chronic patients in paying long-term medical costs.
- PFFS – Private Fee-for-Service plans are specific payment plans, and they propose provider flexibility.
- MSA – Medical Savings Account plans are called medical savings accounts that are combined with high-deductible health plans.
The importance of 3 Cs of MA
The 3Cs of MA are:
- Cost – There is always a limitation on the amount a person will pay from his pocket to avail of healthcare services every year. The out-of-pocket cost is regarded as the amount of money that people pay beyond what is covered under Medicare. A huge benefit of MA plans is that plans put a cap on a patient’s out-of-pocket costs that original Medicare, such as Medicare Part A and Medicare Part B, doesn’t. What people will pay in their out-of-pocket costs varies according to the coverage they choose or the providers they visit.
- Convenience – A person can integrate his prescription drug coverage and medical coverage into one flexible health insurance plan. Several MA plans comprise prescription drug coverage, too. It suggests that people are not required to buy and pay for a distinct Part D plan. When people have an MA, they can enjoy both the convenience and flexibility of having their prescription, medical, and hospital coverage embedded into only one plan.
- Coverage – When people have Medicare Advantage, they get highly personalized healthcare coverage and they are customized to cater to their particular requirements. MA plans, like original Medicare, cover doctor visits and hospital services. Additionally, they provide some health-connected benefits too that patients do not get from the original Medicare. MA plans cover dental, vision, and hearing services besides medically important transportation and fitness club memberships. Nonetheless, people should be mindful that not every MA plan does offer these benefits. Again, the level of coverage and type of coverage too differ by plan. A few of these MA plans confine these benefits to only people who suffer from some conditions.
The verdict
In place of concentrating on medical and hospital benefits like actual Medicare, MA plans take a highly holistic approach. When people need all-in-one and comprehensive coverage, they explore an MA plan as it seems worthy to them. To learn more about Medicare Advantage plans, click here to learn more.
