Often referred to as MA Plans or simply Part C, Medicare Advantage Plans are a comprehensive alternative to original Medicare.
These are Medicare approved plans by private companies that allow you to maintain your Medicare while getting something extra.
These often include Medicare Part B for Medical Insurance, Medicare Part A for Hospital Insurance and Medicare drug coverage or Part D.
What Does It Cover?
Many Medicare Advantage Plans cover a lot of the stuff that isn’t covered by Original Medicare, such as fitness programs, dental care, hearing, and vision. You may also add other things depending on your individual plan.
For instance, certain Medicare Advantage Plans offer cover for things like health and wellness promoting services, over-the-counter drugs, doctor visit transportation etc. Some plans also offer customization to suit those who are chronically ill.
For best results, we recommend you check in with your particular plan to make sure that it offers coverage for the conditions that you need. You should also check your qualification status and be aware of any limitations, if there are any.
Main Rules
The companies that offer Medicare Plans get a fixed amount each month from Medicare, and in return, they must follow certain Medicare rules.
Medicare Advantage Plans typically come with out of pocket costs and rules for services such as:
- When the enrollee requires a specialist referral
- If the enrollee requires the assistance of suppliers, facilities and doctors that are part of the plan’s non-urgent and non-emergency care
Note that these rules change every year so it’s important to check in with Medicare to make sure that they are still the same should you wish to take advantage of certain benefits.
What is the Cost of Medicare Advantage Plans?
The cost of a Medicare Advantage Plan largely depends on a number of different factors.
For starters, you need to make sure that the providers or doctors that you work with are part of the plan’s network and that their services do not cost too much.
Keep in mind that many plans will not cover you if you work with a service provider that’s outside of the designated service area or your plan’s network.
Drug Coverage
A majority of Medicare Advantage Plans for 2021 offer with Part D coverage, or prescription drug coverage.
However, it’s possible to get a separate Medicare Prescription Drug Plan if your plan:
- Doesn’t offer drug coverage, as is the case with the Medicare Medical Savings Account plans
- Doesn’t offer drug coverage, as in the case of the Private Fe for-service plans
If the following conditions, apply, then you may return to Original Medicare from Medicare Advantage Plan:
- If you currently are part of Medicare Advantage PPO or HMO
- If you have a separate Medicare Prescription Drug Plan.
Conclusion
Medicare Advantage Plans are straightforward and easy to choose. As you can see, there are various options to pick from and there’s a plan for everyone.