What You Need To Know About Medicare Advantage
Original Medicare is a federal health insurance program that we are all familiar with. It is available to anyone turning 65 and consists of two parts:
- Part A (hospital insurance) covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, and home health care.
- Part B (Medical Insurance) covers doctor appointments, outpatient services, medical equipment, home health care, and some preventative services.
Many people, however, are not aware that Medicare Part A and B do NOT cover drug prescriptions, dental, vision, hearing, or long-term care. This is where Medicare Advantage comes in, often referred to as Part C.
People with Original Medicare, who are looking to fill gaps in their coverage, can enroll in a Medicare Advantage plan. These plans are offered by private insurance companies that contract with Medicare to provide all of your Part A & B benefits. The most common types of Medicare Advantage plans are:
- Health Maintenance Organizations (HMO)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNP)
- Medical Savings Accounts (MSA)
Most Medicare Advantage plans offer prescription drug coverage (also known as Part D), along with vision, hearing, and dental coverage. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans, and they must follow strict rules set by Medicare. To be clear, if you choose to enroll in a Medicare Advantage plan it will replace your Medicare Part A and B and serve as your sole plan.
Medicare Advantage plans typically come with deductibles and co-pays but unlike Original Medicare, they have an annual out-of-pocket limit. This means that once you pay deductibles and co-pays that add up to the annual out-of-pocket limit, the plan will pay 100% of your medical bills for the rest of the year. Out-of-pocket expenses may add up for some people, so a limit can save money and also offer peace-of-mind.
Not all Medicare Advantage Plans work the same way and it is recommended to take the time to find and compare Medicare health plans in your area. Medicare can be complicated and it is easy to miss important details without professional help leading to dissatisfaction with the plan. But it’s not the fault of the plan, it is simply that many people do not know the rules of the plan before they enroll. All too often Medicare beneficiaries try to enroll in coverage on their own without the free help from a Medicare insurance broker like Empower Brokerage. There are many different Medicare Advantage plans available, and an agent from Empower Brokerage can help you shop around. Agents consider your lifestyle, health condition, and finances while searching for a Medicare Advantage plan to best fit your needs in your area.
What About Medigap? What Is That?
Medigap, also known as Medicare Supplement, is another type of private Medicare insurance that helps fills gaps in Original Medicare coverage – similar to Medicare Advantage. While Medigap only supplements your Original Medicare benefits, Medicare Advantage plans are ways to get Medicare benefits. The top advantage of Medicare Advantage is the price with monthly premiums usually being lower than Medigap. However, not all hospitals and doctors accept Medicare Advantage, and plans often cover fewer expenses. When it comes to which plan is more comprehensive, Medigap has more overall coverage but typically cost more.
Talk To An Expert
The table below compares Original Medicare with a Medigap vs Medicare Advantage. Remember there are several different kinds of plans. If you are interested in joining a plan, make sure to call 1-888-446-9157 and one of our agents will tell you what you need to know about Medicare Advantage and Medigap. You can also click here to get an INSTANT QUOTE