(You must use a network of doctors when electing to sign up on a Medicare Advantage Plan)
What is Medicare Advantage?
The Medicare Advantage program (also sometimes referred to as” Part C”) was created to give Medicare recipients an option to receive a lower-premium plan by obtaining their plan through a Private Insurance Company instead of using Original Medicare. By signing up on a Medicare Advantage Plan, you are agreeing to accept the different benefits of that particular insurance carrier’s plan. When you join a Medicare Advantage plan, the plan pays the providers. Copays, coinsurance, and summary of benefits will differ with each Medicare Advantage plan private insurance company. Medicare Advantage plans are not Medicare Supplement insurance plans; they are entirely different. In fact, Medicare beneficiaries should not be enrolled in a Medigap insurance plan and a Medicare Advantage plan at the same time – you may only select one or the other.
By choosing a Medicare Advantage Plan as your option you must:
- Live in the service area of the plan and be enrolled in Part A and Part B
- Use network doctors, hospitals, and providers
- Answer “No” to the health question of: Do you have end stage renal disease? (kidney failure)
- Obtain a referral from your Primary Care doctor before you can see a specialist (depending on the plan)
- The time frame to make changes to your Medicare Advantage Plan is every year October 15 – December 7 during the Annual Election Period unless you qualify for a special election period
Why Do People Choose Advantage Plans?
- Many of these Medicare Advantage plans have low monthly premiums. However, you must continue to pay your Medicare Part B premium
- Many of the Medicare Advantage plans not only include your Medical coverage but also include your Part D prescription drug benefits as well
- Medical services are paid for as you receive them using copays and coinsurance
- Some of the Medicare Advantage Plan companies offer benefits for things like gym, dental, or vision. However, copays and limitations may apply
What else should I know when considering a Medicare Advantage plan?
Other things to think about before you enroll onto a plan:
- You can only make changes on your Medicare Advantage plan during the Annual Election Period every year unless you have a special election period
- Not all hospitals, doctors, and providers accept Medicare Advantage plans. Be sure to talk to your agent about ensuring your doctors and providers are in the Medicare Advantage plan network you are interested in. Providers also have the option to stop accepting Medicare Advantage plans mid-year
- Medicare Advantage plan benefits change every year. These Medicare Advantage Plan companies will send out a notice each year around September to tell you what is changing regarding premiums, deductibles, formularies, benefits, providers, networks, and pharmacies. Be sure to review that information regarding any changes with your Medicare Advantage plan or call your agent to review the information
At Innovative Insurance Solutions, our goal is to ensure you explore all of your options before making a decision and to be a helping hand in finding a plan that suits your needs. There is no cost for our services. Give us a call today so we can lend you a hand (817) 421-8900.
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