Medicare Advantage Plans Explained

medicare

Medicare is a government insurance plan that is available in four pats: parts A, B, C and D. These parts of Medicare plans have peculiar features. The part A Medicare plan, for example, covers hospital visits. The part B which is also known as medical insurance covers the products and tools utilized during hospital visits. The Part C Medicare plans are the Medicare advantage plans. The part D of Medicare is the prescription plan.

Medicare advantage plans are plans provided by private organizations. The government allows private organizations to fulfill this Medicare obligation. Parts A and B of Medicare plans are referred to as the original Medicare plans, while plans C and D are referred to as Medicare advantage plans since part D is included in Medicare advantage plans. Medicare benefits are thus available as original Medicare plans and Medicare advantage plans.

What do Medicare Advantage Plans cover?

All Medicare benefits apply to Medicare advantage plans. These plans thus offer advantages by offering parts A, B, C and D of Medicare. Medicare Advantage Plans are thus the form of Medicare which offer extra benefits and are administered by private organizations.

Types of Medicare Advantage Plans

Just like other forms of insurance, Medicare Advantage plans are available in different specifications, to serve varying needs. The types of Medicare Advantage plans offered by different insurance companies are highlighted below.

Health maintenance plans

These plans are the most affordable Medicare advantage plans. However, one is required to receive healthcare services from a specified list of providers that are within the network. With this type of insurance coverage, one may also need a referral from their primary care provider to access certain services.

Special needs plans

These Medicare advantage plans are tailored towards the needs of persons with peculiar chronic health conditions. Access to products and services with this plan is guided by rules peculiar to needs of persons with chronic health conditions.

Preferred provider organization

This type of Medicare Advantage plan allows more flexibility, in respect to access to products and services than health maintenance plans although a network of healthcare providers is also maintained. One can receive products and services from providers outside the network, but at a higher price when compared to the cost of visiting an in-network doctor.

HMO point of service

With this type of coverage, one is allowed to seek products and services from outside the network, but at a higher copayment in comparison to the in-network doctor.

Medical savings account: This type of coverage combines a savings account with a high deductible plan. Money is paid into the savings bank account and the money can be used for medical expenses.

Choosing the right Medicare Advantage plan

Insurance companies offer a variety of Medicare Advantage. It is important to understand the costs and benefits as well as guiding rules.

It is noteworthy that one’s access to Medicare Advantage plans can be restricted if the guiding rules are flouted. If a person is in a Medicare Advantage PPO or HMO and has a separate prescription drug plan, their access to Medicare Advantage Plan could be revoked.