Medicare Advantage Plan: Is it the Right Choice for You?

Choosing Between Medicare Advantage Plan and Original Medicare
Original Medicare	Medicare Advantage Plan  (HMO or PPO)
Part A (Hospital Insurance) and Part B (Medical Insurance)	Part C – Comprises of both Part A (Hospital Insurance) as well as Part B (Medical Insurance)
Medicare provides the basic coverage. One gets to choose his/her own physician and hospital etc. Usually, you or your supplemental insurance coverage pays coinsurance and deductibles. A monthly premium is to be paid for Part B Medicare.	This insurance coverage is provided by Private insurance companies which are approved by Medicare. One gets an option of using plan physicians and hospitals or one might also get other providers at higher costs. One usually pays premium in addition to the premium for Medicare Part B. Also pays coinsurance for covered services. The costs, rules and additional coverage differs from plan to plan.
Make up your Mind if you Need Part D Prescription Drug Coverage	Make up your Mind if you Need Part D Prescription Drug Coverage
If you want Part D Prescription Drug Coverage, you ought to select and join some Medicare Prescription Drug Plan. It generally requires paying some monthly premium. These insurance plans are run by private insurance agents who are approved by Medicare.	Normally, people get prescription drug coverage through their Medicare Advantage Plan only. If you insurance plan does not provide drug coverage, then you can join a Medicare Prescription Drug Plan. We are the leading insurer when it comes to Prescription Drug Plans.
Do you need Medicare Supplement Insurance Coverage?	Useful Information:
You might want to get insurance coverage to receive the benefits which Original Medicare does not provide. For this purpose, you can purchase Medicare Supplemental Insurance (Medigap) policy from any private insurance agent. Cost of the policies may vary. Employers may offer similar insurance coverage.	It must be noted that if you buy a Medicare Advantage Plan for you or your family, you won’t be able to utilize Supplemental Insurance policy to pay out-of-pocket expenses which you need to pay for your Advantage Plan. In case you have bought an Advantage Plan, you cannot be sold a Medigap policy.
In addition to Medicare Advantage Plan or Original Medicare, one can also go in for other Medicare health policies. It is possible to save a lot of money and other resources if you have limited income. One can also get additional coverage, like employer, Veterans’ or military benefits.

Assessing Medicare Advantage Plans:

Medicare Advantage Plans have gained huge popularity in a short span of time. It all comes down to the point that how easily senior citizens can have access to health care services. They find themselves better connected with the health care system nowadays.

Private insurance companies sell Medicare advantage plans across the country. You would find different rates offered by two insurance companies for the same product. It is highly advisable to check all the details separately to figure out the best deal. The premium amount turns out to be a decisive factor in the end.

The freedom to consult any doctor, or visit any hospital throughout the United States is the main USP for Medicare Advantage plan PFFS (private fee for service).  The present 2012 version of Medicare advantage plan has more value in comparison to supplement plan, as judged by many people.

Senior citizens have found HMO Advantage Plans to be extremely beneficial.

Medicare HMO plans offer an option to the members to choose a primary care physician (PCP). A doctor would decide that if the patient should be referred to a specialist or not, depending on the conditions.

Advantage Plan Q&A's

Q: Is there a separate special arrangement for Medicare aged persons who are still employed?
A: There is a special period for enrolling in these circumstances, should you have delayed your Part B plan due to the fact that you or a partner are employed and receive group insurance with work. The fact is that you can apply for Part B whether your spouse is currently receiving these benefits within 8 months of having left a group policy.

Q: I often hear the term ‘Medigap.’ Is a Medigap Policy an Advantage Plan?
A: No. Medigap policies, often referred to as Medicare supplementary insurance, are offered by private companies to compensate for the things that Medicare doesn’t cover (the coverage ‘gaps’). Advantage Plans 'take over' Medicare to provide complete medical care and include all sorts of benefits, such as eye care, hearing, dental and often the Part D prescription drug coverage.

Q: Why should one enroll in Part B of Medicare?
A: Part B is required (along with Part A) if you should want to enroll in a managed care plan or a FFS plan. Most Medicare enrollees sign up to Part B hospital cover as it is a worthwhile and good value investment, considering that over 75% of those aged 65+ are hospitalized at least once before they expire.

Q: Does Medicare Advantage cover long term care?
A: The short answer is no. Medicare doesn’t cover what is largely considered to be ‘custodial care’ which is non-skilled and it is therefore not part of the Medicare field of responsibility. It will however pay for skilled nursing facility (SNF) care, provided it is included in your policy. Your agent will help you choose the right policy if this is what you require.

Q: What happens when it comes to pay for a Medicare claim?
A: Your provider is legally required to file the claim on your behalf within that calendar year, however if you go to a provider or pharmacist that is not involved in the Medicare scheme, you must cover the costs yourself as, for instance, Medicare D would only work with those outlets. Those who receive Medicare through managed care, i.e. an FMO or FFS plan, then Medicare pays those insurance companies and the recipient isn’t involved in the process.

Q: Does my family qualify for Medicare on my policy?
A: Medicare policies are issued on an individual basis. That is to say that they only cover the individual who buys the policy and who qualifies for Medicare coverage. If you are unsure about your own eligibility, contact your local licensed agent.

Information on Medicare Advantage 2012

• Medicare Advantage Plans are available with little or no monthly premiums.
• A Medicare Advantage member will continue to receive regular Medicare covered services. In addition, a Medicare Advantage Plan holder will also have access to additional services that neither Medicare supplements nor the original Medicare provides.
• Prescription drug plans often are included in the Medicare Advantage Plan while supplemental Medicare policy holders must pay extra for the Part D prescription plan.

• The demand for Medicare Advantage Plans has grown by many folds. The official reports show that numbers have increased to 8.2 million (as per 2007) from 5.4 million in just two years.

• Medicare Advantage Plans would provide coverage for Medicare-approved services for the remaining part of the year, once the out-of-pocket limit is reached. The condition is that members should use the approved list of doctors provided in the network.

•Recipients of Medicare should be aware of the fact that there will be maximum expense from the pocket even at the time of poor health. Even if the recipient does not see any doctor, he or she is still required to pay $1,500 to $2,500 towards Medicare supplement policy.

• There are other plans like Preferred Provider Organization (PPO) and Private Fee-For-Services (PFFS) where members can move in and out of the network depending on the requirements. You must read each plan separately to know its merits.

• End Stage Renal Disease (kidney failure) can even qualify for the advantages of an Advantage Medicare plan. In some counties we even have companies specifically for people with end stage renal disease.
Our Medicare Supplement agents are proud to be leading pioneers in the Medicare Advantage industry and it would be our pleasure to present you with the best plan that is available in your area.

Click below to read more about the Medicare Advantage Plan:

• Ten Common Questions about Medicare Advantage Plans
• Chart Describing the PPO, HMO & PFFS

Read Complete Guide to Medicare Insurance

jm 556 122 10152011
pg 20 consult w/d 11262011
av 882 220 12152011
rd/303/40/05242012

ht 122 60 06112012