Medicare Advantage Plans
Medicare Advantage
Plans
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A Comprehensive Alternative to Original Medicare
A Medicare Advantage Plan (Part C) is an all-in-one alternative to Original Medicare. Offered by private insurance companies, these plans provide hospital (Part A) and medical (Part B) coverage, with many including prescription drug coverage (Part D). Additionally, many plans offer extra benefits such as vision, dental, hearing, and wellness programs.
What Medicare Advantage Covers
Medicare Advantage Plans are required to provide every medical service covered by Medicare Parts A and B along with additional benefits that commonly include:
- Prescription drug coverage (MAPD plans)
- Routine vision, dental, and hearing services
- Wellness programs and fitness memberships
- Transportation to medical appointments
What Medicare Advantage Does Not Cover
While Medicare Advantage plans offer extensive benefits, they do not cover:
- Long-term care (nursing home or custodial care)
- Cosmetic procedures
- Some experimental treatments
Types of Medicare Advantage Plans
Medicare Advantage plans come in different types, each offering unique benefits and restrictions:
Health Maintenance Organization (HMO)
Requires members to use a network of doctors and hospitals. Referrals are needed for specialist visits.
Preferred Provider Organization (PPO)
Offers a network of preferred providers but allows for out-of-network services at a higher cost.
Point of Service (POS)
A hybrid of HMO and PPO plans, allowing some out-of-network services but at an additional cost.
Who’s Eligible?
To qualify for Medicare Advantage, you must:
- Be enrolled in Medicare Parts A and B
- Live in the plan’s service area
- Use network doctors and hospitals for certain plans (HMO, POS)
Compare Your Options with an Independent Agent
One should always choose Medicare Advantage Plans by assessing coverage specifications with network providers and pricing details. Resorting to independent agents with licenses can help you select the best plan according to your needs.