Health Insurance Benefit Program
Medicare Advantage plans can be distinguished from Medicare supplement coverage by having many differences. My clients are advised to consider Medicare Advantage plans an alternative 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 does not cover Medicare Advantage plans. Medicare Advantage plans must include all services.
Original Medicare providers first bill Medicare, then they bill a supplement company. After Medicare and the private supplement companies have paid their respective portions, the individuals could be responsible to pay the remainder. 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. In this instance, the individual might be responsible to pay a copay or deductible.
Medicare Advantage plans are sometimes called “all of the above” because they provide coverages beyond medical. Part C plans typically include prescription drug coverage. These plans are sometimes referred as MAPD plans (Medicare Advantage prescription drug). 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 may have a premium. These premiums can be very different. Some plans have a $0 monthly cost. However, Medicare Advantage plans do not require individuals to pay the Part A premium in order to sign up. Access to a plan varies by county. For example, in one county, a $0 monthly premium policy may be available. However, it may not be in another.