Health Insurance Benefit Program
Medicare Advantage plans offer many advantages over Medicare supplements. My clients should consider Medicare Advantage plans as an alternative to Original Medicare coverage. Original Medicare includes Parts A, B and Medicare Advantage plans are sometimes called Part C or MA plans. Original Medicare does not cover Medicare Advantage plans. Medicare Advantage plans must include all services.
Original Medicare allows providers to bill Medicare initially and then later bill a Supplement Company. After Medicare and private supplement companies have paid their portion, individuals might be responsible for the rest. Medicare Advantage plans have the private insurance company being billed. If an individual has a Part C plan (MA) with company XYZ, and visits his primary physician or receives services at a hospital for treatment, the bill will go to company XYZ, not Medicare. This could mean that the individual will be responsible for either a copay, or a maximum amount.
Medicare Advantage plans may sometimes be called “all-in one” plans. This is because they offer additional coverages. Part C plans typically include prescription drug coverage. These plans are commonly referred to by the MAPD (Medicare Advantage Prescription drug) plan. Some plans provide coverage for vision, hearing, dental, wellness, and/or other benefits. Medicare Advantage plans are very diverse and should be reviewed individually.
Medicare Advantage plans may have a premium. These premiums may vary. Some plans have a $0 monthly cost. However, to be eligible for Medicare Advantage plans, the individual must still pay the Part B premium. Access to plans varies from one county. A $0 monthly premium plan, for example, may be available in one county but not in another.