In this respect Medicare Advantage Plans REPLACE the Original Medicare with Combined Coverage that will provide all of
your Part A (Hospital Insurance) and Part B (Medical Insurance) benefits and adds additional coverage towards the deductibles and co-payments that were Not previously covered by Original Medicare Part A and Part B.
Many Medicare Advantage Plans also offer extra coverage, such as vision, hearing, dental, and general checkups for preventive reasons.
Many of the Medicare Advantage (MA) Plans include Medicare prescription drug coverage (Part D) embedded in the plan and are known as MAPD plans.
This should simplify administration as there is no need for two or more companies to coordinate the payment of benefits. When an insured person receives medical care, or if they go to the pharmacy to get a prescription filled for their medication, they need only show to the Care Provider the One Medicare Advantage Card. One Company will pay all of the Medical Expenses which are listed as Covered Benefits of the Plan.
Medicare Advantage Plans are Managed Health Care Plans, like Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). These plans may require you to choose a primary care physician (PCP) and get a referral from your PCP to see a specialist. These Plans also may require you to use only doctors, hospitals, and other medical facilities and services that are part of that particular health plan's provider network.
Medicare Advantage Plans are far less costly on a Monthly basis than Medicare Supplement Plans. In Fact, Many Medicare Advantage Companies offer $0 Zero Premium Plans which Do Not Charge a Monthly Payment at all, yet they offer an Insurance Plan that covers More Medical Expenses than Original Medicare alone. Many plans provide Some benefits for Extra Services that Original Medicare doesn't cover, like Dental, Vision, and Hearing. These Plans wouldn't be considered to include Comprehensive care in these areas, but you might expect to have dental, vision and hearing checkups and simple services, like dental cleanings included 2 times per year.
These plans will require co-payments whenever a Member of the plan receives Medical Care. The Medicare Advantage Companies create their Plans following a Structured Plan of the Minimum Level of Medical Treatments that must be covered. The Minimum Care covered is set by Medicare however, the Insurance Companies are allowed to offer More coverage if they choose.
In addition,each Medicare Advantage Plan can require different co-payments and out-of-pocket costs and also have different rules for how your services will be received (like whether you need a referral to see a specialist or whether you can go out-of-the network of doctors to receive Medical Care).
The Costs and Rules of Medicare Advantage Plans vary by company, vary by plan and the Costs and Coverages change each year.
For this reason, you might think It Is Best to consult AN INDEPENDENT INSURANCE AGENT who is authorized to offer Plans from a variety of Insurance Companies. An Independent Agent can help you understand the differences in the Benefits of the Available Plans. Also An Independent Agent can help you find the Lowest Cost Plan for you among the Many Carriers who offer Plans with similar coverages.
When you are planning for your future health care, it's not only important to have the best Plan available, it is also important to have a good Agent who will keep you informed when the Costs of different Plans change or when New Plans become Available so that you can make the changes necessary if the time comes where it is cost effective for you to change your plan.
Medicare Advantage - Eligibility and Enrollment
In order to "purchase" or enroll in a Medicare Supplement Plan a person must first be enrolled in Original Medicare Part A & Part B. Medicare Advantage is intended to replace Original Medicare and cover the Expenses that Original Medicare Part A & Part B would cover, so you must be eligible and enrolled in Original Medicare and you must continue to pay your Part B premium and any applicable Medicare Advantage premium to remain enrolled in the Plan.
Medicare Advantage Plans are traditionally "purchased" by people who are just turning 65 years of age. They are often said to be Aging-in to Medicare. As mentioned in an earlier section, if you are under 65 with certain disabilities you may become Eligible for Original Medicare, and thus eligible to enroll in a Medicare Advantage Plan, as well.
The Vast Majority of Medicare Beneficiaries will Age-in to Medicare, and they will be Eligible to Enroll in a Medicare Advantage Plan or to choose a Medicare Supplement Plan during the Initial Enrollment Period (IEP), which is a 7 month period including the 3 months before the month of a person's 65th birthday, the month of their 65th birthday, and the 3 months after.
During this Initial Enrollment Period (IEP) an insurance company cannot refuse to sell you or enroll you into any Medicare Advantage plan it offers, even if you have serious pre-existing medical conditions. This excludes End-Stage Renal Disease (ESRD). A person with ESRD will not be accepted into a Medicare Advantage Plan.
Anyone who has allowed the Initial Enrollment Period (IEP) to end and has no other plan in place, would have to wait until the Annual Election Period (AEP) which takes place from October 15 thru December 7. During this period individuals can Apply for and will be guaranteed approval for a Medicare Advantage Plan.
As you can see there are many details involved when you are planning for your future Medical Coverage. With some effort and education you can learn everything you need to make an informed decision about whether a Medicare Advantage Plan is best for you and how best to plan your Medicare coverage.
But there are issues that might cause confusion, like enrollment periods and existing insurance policies, and the many different Medicare Advantage Plans and their benefits. Finally, there is the fact that Insurance Carriers offer the Medicare Advantage plans that provide similar coverages, yet they will require different Monthly Premiums and different co-payments for essentially the same services.
For this reason, you might think It Is Best to consult AN INDEPENDENT INSURANCE AGENT who is authorized to offer Plans from a variety of Insurance Companies. An Independent Agent can help you understand the Enrollment Process and also the differences in the Benefits of the Available Plans. Also An Independent Agent can help you find the Lowest Cost Plan among the carriers who offer the Same Standardized plan.