What is a Medicare Advantage Plan?
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all of your Part A and Part B benefits.
Advantage plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. If you are enrolled in one, your Medicare services are covered through the plan and are not paid for under Original Medicare. Most Advantage plans also offer prescription drug coverage.
What Medicare Advantage plans cover
Advantage plans must cover all of the services Original Medicare covers, with one exception: hospice care, which Original Medicare continues to cover even while you are in an Advantage plan. In every type of Advantage plan you are always covered for emergency and urgently needed care.
Plans may offer extra coverage — vision, hearing, dental, and health and wellness programs — and most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Advantage plan itself.
You can also ask the plan for a written advance coverage decision to confirm a service is medically necessary and will be covered. If the plan will not pay for a service you believe you need and you did not ask for an advance decision, you will be responsible for the full cost.
Why these need reviewing every single year
Advantage plans change their networks, their formularies and their extras annually. A plan that was the obvious choice last October can quietly drop your cardiologist or move your prescription to a higher tier for the coming year.
We re-run the comparison each year against your actual doctors and your actual medication list. Most years nothing changes. The years something does change, you will be glad somebody looked.
Talk to us about the right Medicare Advantage plan for you.
Based in the Coastal Bend? Medicare help in Corpus Christi and the Coastal Bend.