Medicare Advantage

Medicare Part C is commonly referred to as Medicare Advantage. It offers the same coverage as Original Medicare, minus the hospice care, but also includes extra benefits that you would not receive with Original Medicare.

To be eligible for a Medicare Advantage Plan, you must already be enrolled in Medicare Parts A and B. If you drop your Part B coverage, you will lose your Medicare Advantage Plan.

Medicare Advantage Coverage

Besides offering the same coverage as Original Medicare, some of the extra benefits include:

  • Prescription drug coverage
  • Gym memberships
  • Wellness programs
  • Nutrition programs
  • Transportation for doctor appointments
  • Dental, vision, and hearing coverage

Medicare Advantage Plans

There are several types of Medicare Advantage Plans:

  • HMO: Health Maintenance Organization (HMO) Plans typically require the beneficiary to choose a primary care physician within the plan’s network of providers. The plan also requires referrals to see a specialist. If the beneficiary receives care or treatment outside of the plan’s network, the plan will not cover the costs of the services received unless it is an emergency. HMO Plans also have a lower premium payment.
  • PPO: Preferred Provider Organization (PPO) Plans do not require referrals or primary care physicians. They also do not limit the beneficiary to a specific network of providers. However, because of the flexibility, there is a higher premium.
  • PFFS: Private-Fee-For-Service (PFFS) Plans do not require referrals or primary care physicians and may also allow the beneficiary to receive care outside of the plan’s network. With PFFS Plans, the insurance company determines what it will pay your provider and what you will pay for a healthcare service. 
  • MSA: Medicare Medical Savings Account (MSA) Plans combine a high deductible plan and savings account to pay for medical costs. To start receiving coverage, the beneficiary must pay the high deductible in full. With the savings account, the plan provider will deposit a certain amount into it every year that can be used to pay on the deductible. However, the amount deposited will always be less than the deductible. The beneficiary also cannot deposit their own money into the account.
  • SNP: Special Needs Plans (SNP) are specifically tailored and limited to certain people who have certain diseases or illnesses. With an SNP, the beneficiary may be required to choose a primary care physician, obtain referrals to see specialists, and receive care or treatment only within the plan’s network. All SNPs provide prescription coverage.

To learn more about your Medicare Advantage options and which plan is available in your area, reach out to Barnhart Insurance Group today.

Barnhart Insurance in Leonard, Michigan

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