What is included in the Medicare Advantage Plan?
What is included in the Medicare Advantage Plan?
- Medicare Advantage (Part C) combines Medicare Part A and B coverage with additional benefits such as dental, vision, hearing, and more.
- Medicare Advantage is sold by private insurance companies.
- When you purchase a Medicare Advantage plan, your costs will depend on where you live and the plan you choose.
If you are looking for a Medicare plan, you may be wondering what is covered by Medicare Advantage (Part C).
The Medicare Advantage plan includes everything that was included in the original Medicare plan, such as hospital and health insurance. However, most Medicare Advantage plans also include additional health-related services such as prescription medications, eye care, and dental services.
In this article, we’ll take a look at what Medicare Advantage includes and other considerations if you’re considering purchasing this type of plan.
What are Medicare Benefits?
Medicare Advantage, also known as Medicare Part C, is a type of insurance plan that offers basic Medicare coverage along with additional benefits. Medicare Advantage is sold by private insurance companies that have contracts with Medicare.
There are different types of Medicare Advantage plans that you can choose from depending on your needs. This includes:
- Health Maintenance Organizations (HMOs). The HMO plan stipulates that you can only get services from doctors and network facilities. Specialists need referrals outside the network.
- Preferred Service Provider Organizations (PPOs). PPO plans to charge different rates for doctors, providers, and hospitals depending on whether they are in the network. You will pay more for offline services.
- Private Fee for Service (PFFS). Paket PFFS memungkinkan Anda mendapatkan layanan dari penyedia mana pun selama mereka menerima persyaratan pembayaran paket PFFS Anda.
- Rencana Kebutuhan Khusus (SNP). SNP ditawarkan kepada kelompok orang tertentu yang membutuhkan perawatan jangka panjang untuk kondisi kronis.
- Rekening Tabungan Medicare (MSA). Paket MSA menggabungkan rencana kesehatan yang dapat dikurangkan dan rekening tabungan medis di mana Medicare menyetor uang untuk digunakan untuk layanan medis.
Anda memenuhi syarat untuk Medicare Advantage setelah mendaftar di Medicare Bagian A dan Bagian B.
Medicare Advantage Plans offer hospital and health insurance, as well as additional coverage. Depending on the package you choose, you may also receive:
- Prescription drug insurance. While not usually offered under the original Medicare program, nearly all Medicare Advantage plans offer prescription drug coverage.
- Dentistry, vision, and hearing. This includes non-medical coverage that was not offered in the original Medicare program. Most Medicare Advantage plans vary in how much of these options are covered.
In addition, some companies offer other health-related benefits through their Medicare Advantage plans, such as gym memberships, medical transportation, and food delivery.
How much does Medicare Advantage cost?
When you sign up for a Medicare Advantage plan, your costs will vary from plan to plan and where you live. Medicare Benefits Plans may have their own monthly premiums and annual deductions, which are sometimes added to your Part B premium.
One of the benefits of a Medicare Advantage plan is that there is an annual cap on most other personal expenses, which can help keep your overall costs down.
The total cost of a Medicare Advantage plan is usually determined by premiums, deductions, co-pays, how often and where you get service, the type of service you need, and whether you get Medicaid.
Given all of these factors, there are no specific fees for the Medicare Advantage Plan. All of these are important to consider when comparing plans.
Medicare Advantage Plan Pros and Cons
While a Medicare Advantage plan may seem like an easy option for coverage, consider the pros and cons of Medicare Advantage:
- Many Medicare Advantage plans offer additional coverage that the original Medicare program did not offer, such as prescription drugs, dental services, vision, hearing, and more.
- Medicare Advantage Plans offer network services that are easier to coordinate.
- Study shows that Medicare Advantage plans can result in lower health care costs than the original Medicare program.
Disadvantages of Medicare
- Depending on which plan you choose, you may be limited in what your provider can do.
- If you need to see a specialist for a specific condition, you may need a referral.
- If you travel, your out-of-town service may not be covered.
Other Medicare Benefits Considerations
You can use the Medicare Advantage Plan if you want full Medicare coverage and more. If you’re interested in prescription drug coverage and annual dental and eye care appointments, the Medicare Advantage plan is a great option.
If you have a chronic condition, SNP can help cover some of the costs of long-term treatment. You can also use the MSA plan if you want to have money for various health care services throughout the year.
However, if you don’t think you need extra protection for things like your teeth, vision, hearing, or prescription medications, a Medicare Advantage plan might not be right for you.
The same is true if you want the freedom to choose your own supplier. If you need coverage out of town, the Medicare Advantage Plan may not be able to help cover these unexpected medical expenses.
Help someone choose a package.
If you are helping a family member or friend choose a Medicare Advantage plan, you should consider the following:
- What coverage do they need? Are they only interested in prescription drug coverage, or are they also interested in dental or vision insurance? Are they interested in other medical services?
- What personal expenses can they afford? Consider whether the MA plan includes a premium or deduction, the monthly and annual costs of the plan itself, and how often and how much medical care is needed.
- What types of Medicare Advantage plans are they interested in? Is the HMO plan best suited to their needs, or is a PPO or MSA plan better for them? Do they have special long-term expenses that can only be covered through SNP?
- What other factors may influence their medical needs? Are they traveling or needing treatment out of state due to certain conditions? Are they prone to certain conditions that require future referrals or offline visits?
Medicare Advantage Plans offer medical coverage beyond what Medicare Parts A and B can offer. These may include additional medical services such as prescription medicine, ophthalmology, dentistry, and more.
While some Medicare Advantage plans have more costs on their own, others can help you save on long-term medical expenses.
Not everyone needs a Medicare Advantage plan, so consider your medical and financial needs before choosing the type of Medicare that’s best for you.