Questions that you may have about a Medicare Advantage plan

What is a Medicare Advantage Plan?
Medicare Advantage Plans are the newest option for Medicare recipients. Prescription drug coverage is often included in the Advantage plan.

 

The Advantage plans include the Preferred
Provider Organizations (PPO), the Private Fee-for-Service (PFFS), and the Health Maintenance Organizations (HMO) plans. Medicare recipients may choose among the Medicare Advantage plans in their area. Private insurers manage the program.

How is eligibility determined?
Having Medicare Part A and Part B are required. End stage renal disease is the one disqualification. Otherwise, there are no medical questions.

Are Medicare Part B premiums required to be paid ($93.50 in 2007)?
Yes. Regardless of which Medicare Advantage Plan the Medicare recipient chooses, one will continue paying the Part B monthly charge.

Is the Federal government and Medicare still in charge?
Yes. The Federal government is the ultimate arbiter for all Medicare decisions. The Advantage plan member will have rights and protections that are protected by the Federal government.

Is the Advantage Plan complicated and difficult to understand?
No. The Medicare Advantage plan is simple with no hidden costs. Your out of pocket expenses will be the monthly premium as well as the co-payments and coinsurance amounts that are defined on the sales material and the Medicare Advantage plan contract

Why is the Medicare Advantage plan beneficial?
• Advantage Plans usually have lower co payments, lesser out of pocket expenses as well as extra benefits as opposed to the original Medicare plan.
• Little or no monthly premiums are available in certain parts of the USA.
• Part D prescription drug coverage is often included.
• A Medicare supplement is not needed, saving thousands of dollars per person.

Are there options available?
Yes. The various Advantage Plans all meet the government's strict regulations, but different plans will differ in consumer costs and coverage. Many options are available and it is worthwhile to analyze the available Medicare Advantage plans to choose the best plan for you.

Are there any enrollment restrictions?
There is a an enrollment beginning November 15, 2006 and ending March 31, 2007. Those who are not enrolled with a Medicare plan by March 31 will not be able to enroll in an Advantage plan till January of the following year.

Are Medicare Advantage plans required?
The Advantage plans are not required but the superior benefits being offered is certainly very hard to refuse.

What is the Prescription Drug Plan (Part D)?
The Part D prescription drug coverage can be included in the Medicare Advantage plan or can be purchased separately in conjunction with a supplementMedicare or the original Medicare. The prescription plan is insurance. Private insurers offer the coverage. You choose particular Part D plan and pay the premium. Medicare and the federal government is subsidizing the Part D premium.