What Is a Medicare Advantage Plan?
Individuals aged 65 and older, or those younger than 65 with certain medical conditions or disabilities, are eligible to sign up for Medicare, which is federal health insurance. Medicare Advantage plans offer additional coverage to original Medicare.
Also known as advantage plans or Medicare Part C, they’re offered by private companies approved by Medicare. They’re typically a good option for obtaining broader coverage. To be sure you make the best choice during open enrollment, however, it’s advisable to work with a trained, experienced independent health insurance agent who works for you and not an insurance company.
Asheville-based Lanford Insurance & Financial Services specializes in Medicare Advantage and health insurance plans. They can answer any questions you have about your options while helping you find the best plan for your needs. These experts keep up with all the changes that federal programs undergo and, during open enrollment, help you take advantage of the best Medicare Advantage plan for you.
What’s Included in Medicare Advantage Plans?
Medicare Advantage plans are bundled plans that include coverage for hospital insurance, which is Medicare’s Part A, as well as Medicare Plan B coverage that includes doctor visits, medical equipment and preventative services. These plans may also include additional options, such as:
- Vision insurance
- Hearing loss coverage
- Dental insurance
Drug coverage, or Medicare Part D, is usually included in Medicare Advantage plans as well. Some plans include additional services, such as transportation to doctor visits or other features that promote wellness, including gym memberships or health product discounts.
How Do Advantage Plans Medicare Options Differ from Traditional Medicare?
Both Medicare and Medicare Advantage plans include coverage for both Part A and Part B. But there are some differences between these two plans, such as:
- Hospice care. Medical services covered by original Medicare are covered by Medicare Advantage plans except for hospice care. If you have an advantage plan, hospice care is only covered under original Medicare.
- In-network vs. out-of-network. If you select original Medicare, you can go to any doctor that takes Medicare in the U.S. Medicare Advantage plans often provide coverage only when you visit in-network doctors.
- Referrals. Medicare Advantage may require referrals to see a specialist, while original Medicare doesn’t.
- Supplemental insurance. With traditional Medicare, you may need supplemental insurance to help pay copays and other out-of-pocket costs. This isn’t needed for Medicare Advantage plans.
For many seniors, cost affects the decision on which option to choose. Original Medicare pays its share of medical costs after a deductible is paid. For Part B services, the insured is usually responsible for 20 percent co-insurance costs, and there’s no annual limit on the amount paid out of pocket, unless you also have supplemental insurance.
Which Medicare Advantage Plan is Right for Me?
Medicare Advantage plans may have lower out-of-pocket costs, and most Medicare Advantage plans do have a yearly limit on out-of-pocket costs. Additionally, you’ll find a plethora of open enrollment Medicare Advantage plans, depending on where you live. That’s just one more reason to seek the advice of a professional who studies these plans before helping you make a decision. During open enrollment, Medicare options are sometimes unclear. Also, various plan benefits can change each year. Don’t struggle with unanswered questions on your own. Contact the professionals at Lanford Insurance & Financial Services during open enrollment to find the best Medicare Advantage plans for you and your family.
