Is a Medicare Advantage Plan the Right Choice for You?

There are two primary options when buying Medicare coverage.
Follow these steps to help you make up your mind as to which one to choose:

Evaluating Medicare Advantage Plans:

Medicare Advantage Plans are the result of legislation that has recently been enacted. These plans are becoming tremendously popular due to the extra benefits that are offered. Extra days in the hospital, low out of pocket costs for doctor visits and affordable prescriptions, are some of the common extra benefits usually offered.

The Medicare Advantage Plan is offered throughout the United States via private insurers. Part A and Part B of Medicare are required to join the plan, and the Medicare part B premium must be paid by the Medicare recipient in order to enroll. Private insurers offer plans which have varying co-payments and premiums that start at $0 per month.

A Medicare PFFS (Private Fee for Service) Advantage plan is enjoying explosive membership growth because it allows the Medicare recipient to visit any doctor, any hospital in the United States. Currently (2012) the Medicare PFFS Advantage plan is asuperior value versus the supplement for most people.

The HMO (Health Maintenance Organization) Advantage plan continues to be popular for those who desire to have minimal out-of-pocket expenses, and low (usually zero) monthly premiums.

Medicare HMOs are offered in metropolitan areas that have large Medicare recipient populations.

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?

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.

Here's the story with Medicare Advantage Plans:

• Medicare Advantage Plans are available with little or no monthly premiums.
• Medicare Advantage Plan holders are still in Medicare and retain the rights and protections of Medicare.
• 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 Medicare Advantage Options are growing. The Medicare Advantage Plans are now offered to 98% of the counties in the United States. In 1996 only 15% of American counties had a Medicare Advantage Plan available.

• Supplemental Medicare policy holders pays money whether you get sick or not. Medicare Advantage Plans have the the policyholders make a small co-payment for doctor visits and a somewhat larger co-payment for hospital visits.

• The Medicare recipient should know that the Medicare Advantage guarantees that even in a time of poor health there is a maximum out of pocket expense. A Medicare supplement (Medigap plan) policy guarantees the Medicare recipient to spend $1,600 to $2,000 a year even if you never go to the doctor.

• A primary physician (PCP) referral to see a specialist is a thing of the past. A PFFS or PPO Medicare Advantage Plan permit the policyholder to go to any doctor or hospital with no referrals!

• 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

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