Medicare Advantage

What are Medicare Advantage Plans?

Medicare Advantage plans are health insurance plans approved by the Centers for Medicare and Medicaid Services (CMS) and provided by private insurers. These plans are called ‘Part C’. Medicare Advantage plans have doctors in HMO or PPO networks. Medicare Advantage plans provide the same benefits as Original Medicare, Parts A and B, with additional benefits which Original Medicare does not include. Most Medicare Advantage plans include drug coverage.

Medicare Supplement Insurance (Medigap) versus Medicare Advantage

When choosing between Medicare Advantage and Medigap Plans, we recommend that you consider the following: monthly premiums; deductibles; benefits offered; frequency of care; medication copays and the maximum out of pocket spending for each plan.

How Do Medicare Advantage Plans Work?

Created as an alternative to traditional Original Medicare only and Medigap plans; Beneficiaries direct Medicare to pay the Advantage Plan Insurance Company a fixed monthly fee for a member’s care. The plans assume responsibility for delivering a member’s health related services, (excluding hospice care). Further, the plans assume all of the member’s medical risk. Members are required to pay their Part ’B’ premiums while enrolled and to live within the plan’s service area.

Choosing between Medicare Advantage and Medigap

Factors to be compared when deciding between a Medicare Advantage Plan and a Medigap Plan: Monthly premiums Benefits offered Deductibles, if any Expected costs of healthcare services on each plan How often you use healthcare services Expected copays for your medications Potential out of pocket spending on each plan type As with anything government does researching provider networks and drug formularies can be, and usually is, a complex time-consuming process. At Andea Insurance Services Inc. our licensed agents do this research each and every day. We will research the plans in your area, show you which plans your doctor and hospital take. Also, estimated costs and whether your meds are covered. As valuable as that service is our greatest value to our clients is our back office support. Did a carrier deny a bill; have a problem with carrier billing or coverage issues? Andea Insurance Services Inc. is YOUR back office support network we’re there to fight for you.

Have more questions? Need help finding the carrier your doctor and hospital take? Call or email!
Call: 818 468-4289
Email: Andea@AndeaInsurance Services.com

 

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