Health Insurance Benefit Program
Medicare Advantage plans can be distinguished from Medicare supplement coverage by having many differences. My clients often think of Medicare Advantage plans in addition to Original Medicare coverage. Original Medicare covers Parts A and BC. Medicare Advantage plans, also known as Part C or MA plans, are part of Original Medicare. Original Medicare only covers Medicare Advantage. Medicare Advantage plans must also cover all services not covered by Original Medicare.
Original Medicare has providers billing Medicare at first, and then a supplement firm. 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 who has a Part C or MA plan with company XYZ visits his primary doctor, or receives services in a hospital setting, the bill will be sent not to Medicare but to company XYZ. An individual may have to pay a copay (or deductible) for the services received.
Medicare Advantage plans may sometimes be called “all-in one” plans. This is because they offer additional coverages. Part C plans may include prescription drug coverage. These plans are also known as MAPD (Medicare Benefit Prescription Drug) plans. Some plans provide coverage for vision, hearing, dental, wellness, and/or other benefits. Medicare Advantage plans come in many forms and must be evaluated individually.
Medicare Advantage plans can have a premium. These premiums can vary greatly. There are plans that offer a $0 monthly Premium. However, Medicare Advantage plans do not require individuals to pay the Part A premium in order to sign up. The availability of plan access can vary greatly from one county to the next. A $0 monthly premium plan, for example, may be available in one county but not in another.