Medicare Advantage plans are medical insurance with high coverage. So throughout this article, we will be answering some very common questions that many seniors have about these plans while informing you as to what a Medicare Advantage plan is exactly.
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What Does Medicare Advantage Cover?
When you are trying to understand a plan or want to know if a plan is right for you, you first need to know what medical expenses you have to have covered. These expenses are those that you have to pay out-of-pocket. This insurance plan is designed to cover a great majority of these charges. They offer some coverage for everyone, even if they only pay a certain percentage per incident. Sometimes, before you can receive the coverage from your insurance plan, you might have to cover deductibles and co-payments.
When you sign up for an Advantage plan, you are getting coverage for all of the items covered by Original Medicare, including Parts A & B. A lot of people might not know everything that entails. So, we will be covering the specific services and costs that this coverage will help you with. You will get coverage for outpatient and inpatient expenses related to clinic, doctor, and hospital visits. This includes services like:
- In-room Expenses
- Ambulance Services
- Some Prescribed Medications
- Some Checkups
- And Many Tests
While they do cover all of basic Medicare’s plan, Advantage plans extend much further than just that. You also get coverage for medical care that is determined to be urgently needed. This includes lifesaving treatments, medications, and more. There is also a good amount of emergency care, covering the ER costs.
The Medicare Part A, Part B, Urgent medical care, and other emergency services are all included in the basic Advantage plans. However, many of these plans do go the extra mile, adding more coverage for its beneficiaries. You are able to purchase Advantage plans from private insurers, this means that these insurers are able to decide the coverage that you get with the basic coverage. Also, they also determine the price that they charge for these plans. So comparing Medicare Advantage plans in between insurance companies is important to find the right plan for the right price.
As we stated before, the insurance company decides what Advantage plans cover, so you will see a difference between one plan to the next. However, many of the plans do cover Part D of Medicare. This is a powerful prescription drug plan. If you find that you need this Part D coverage, but it isn’t included in your Advantage plan, you are able to purchase it as a standalone plan.
There are several insurance companies that choose to include the coverage for hearing aids, eyeglasses, and other medically relevant items you may need. You also often get coverage for many checkups. These checkups are usually for hearing, vision, or general wellness.
These items listed are only some of what a provider could include with the basic coverage. However, some companies won’t sell more than the basic plan. You will find that a majority of insurance providers will provide a good amount of coverage options for you to choose from, forming and Advantage plan that is suited for you.
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Getting Medicare Advantage
There are some minimum requirements that must be met in order for you to be able to sign up for an Advantage plan. It isn’t a long list, but there are some eligibility requirements nonetheless. Here are the requirements that you need to know about in order to qualify for Medicare Advantage.
For starters, you must be 65 or older, though there are some exceptions to this rule. Upon turning 65, being approved for an Advantage plan is easy once you apply. Also, you have to be a citizen of the United States.
Having Original Medicare isn’t a requirement, as it is included in the Advantage plan. That means, whether you apply for it or not, you are going to be getting this coverage with Advantage. Most seniors do get approved when they apply, regardless of their existing health conditions.
If you are younger than 65, when you apply, the coverage won’t kick in until after you have turned 65. So if you plan on applying early, make sure it is close to your 65th Birthday.
Having a work history isn’t required to qualify for Advantage plans. However, had you worked and paid taxes, you will be able to cut some costs. The way you cut those costs is by enjoying reduced rates on certain aspects of your policy, and not having to pay specific premiums.
There is a time frame to apply for an Advantage plan known as the OEP or Open Enrollment Period. This time frame spans from October 15th to December 7th. During the OEP, you are almost guaranteed approval for your chosen plan. Applying outside the OEP could result in your application being denied. That is why it is recommended that you only apply during this period of time.
You are able to consult an agent of Medicare in order to determine if you are eligible for approval of Medicare Advantage plans prior to turning to 65. A majority of people with disabilities, or who have a renal disease in the end stages, are approved before they turn 65.
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What Does Medicare Advantage Cost?
Advantage plans are accompanied by monthly premiums. These premiums will vary in cost between insurance companies. Insurers are able to set whatever price they feel the plan is worth, and there is no restriction on set from Medicare to regulate how high the price can go.
From year to year, these plans are subject to change. In order to keep up to date on these plans and their prices, you are able to use our site. We offer tools that help you compare plans and prices while keeping track of the changes that may occur. It is an easy way to quickly source quotes and compare plans in order to find the best savings and coverage for your specific needs. Think about it, would you rather contact every individual private insurer to get quotes, or use a simple tool that does the hardest work for you?
Comparing the prices of Medicare Advantage plans comes easy once you are aware of the coverage it provides. The goal when comparing prices is to find the most for your dollar. You want the plan to cover what you need, but the price has to be right. So make sure you are using our tool to make an informed decision.
Monthly premiums aren’t the only cost you have to be aware of. Medicare Parts A & B come with deductibles and co-payments that you also have to deal with out-of-pocket. Some of these costs may be covered by your Advantage plan, which is, however, dependent on the plan and situation you are in. For example, you could be exempt from some payments depending on how long you have worked and paid taxes during that time. An insurance agent will be able to inform you which costs you will have to pay out-of-pocket upon signing up for an Advantage Plan.
Compatibility of Medicare Advantage
Not every insurance plan will be compatible with Medicare Advantage. That means you may have to decide between dropping your current plan for Advantage or sacrificing the coverage that Advantage plans offer. This only occurs if there is an overlap in the plans.
Medicare Advantage will not work with any Medicare Supplement plan. The reason being, there will always be an overlap between these two types of plans. You will have to choose either Advantage or Supplement.
If your plan includes Part D, you won’t be able to sign up for it separately as there will be overlapping coverage. It doesn’t do anyone any good to pay for the same service twice, so doubling up on coverage isn’t allowed.
Often times, medical coverage provided by a union or employer will not be compatible with an Advantage plan. Make sure you are looking at your plans to see if there is an overlap before you sign up for a Medicare Advantage plan.
2021 MEDICARE ADVANTAGE
Advantage and Networks
Even in the event that you purchase a robust plan, you should be aware that you won’t be able to receive your coverage everywhere you may go for medical services. This is because Medicare Advantage plans work on networks of approved, and cooperating medical facilities that honor the policy. However, there may be some insurance companies that are accepted at these facilities. That is why it is important to compare plans, and networks, in order to find something right for the area you live in.
A network is a group of doctor’s offices, clinics, hospitals, and other facilities that approve and honor the plan provided by your insurance company. If you go outside the network, you will face many out-of-pocket costs. You may receive partial coverage depending on the type of Medicare Advantage you have.
There are two basic choices of networks with Advantage plans. You are able to choose from an HMO plan or a PPO plan. There are other options available, they are just not as common.
When you go off a network with a PPO plan, you may still receive some coverage. When you are on your network, you receive the full coverage of your policy, but this expensive coverage does help with partial costs. This is one of the more popular types of Advantage plans. However, it is a bit more expensive then what you would pay for an HMO. Having coverage everywhere does make up for the increased price tag.
Unlike the previously mentioned plan, an HMO plan will not cover you off-network at all. You get full coverage when you use a facility on the network. However, it is cheaper than a PPO plan.
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Where You Can Buy Advantage Plans
If you are looking to buy an Advantage plan, then you have several options to choose from as to where you purchase them. It should be mentioned that you are not able to purchase a Medicare Advantage plan through Medicare. Instead, only Medicare-approved private insurers may sell these plans.
Though Medicare can’t dictate the price or the plan’s coverage, it does have the ability to force an insurer to stop selling a plan that they deem to be a bad option. If the plan doesn’t offer the customer much value, they will have that plan removed from the market. Medicare will evaluate these plans yearly.
Here are a few of your options on where you can buy Medicare Advantage plans from:
Partnered with United Healthcare, AARP has been providing relevant coverage to seniors for a very long time. They have all types of services that they offer, such as:
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Mutual of Omaha
This company boasts it’s exceptional customer service, which is backed by a record that is nearly flawless. They are considered to be a top pick for seniors that are trying to find comprehensive coverage.
With Humana, you are able to take advantage of an amazing selection of healthy living benefits. Their primary concern is that their beneficiaries are well taken care of medically, with the appropriate coverage and networks that will ensure a healthcare provider is available in every area. They have a wide array of insurance plans to choose from, which does include Advantage offers.
For multiple decades, Cigna has been recognized as one of the top-ranking insurance providers for senior’s health. They make it easier for seniors to stay connected to their coverage with cutting edge technologically advanced services. Their services work across most of your devices.
Finding the Best Deal for Advantage Plans.
Medicare advantage has offered hundreds of thousands of seniors potential ways to save thousands of dollars on healthcare expenses. These plans will provide coverage that is not only powerful but comprehensive and relevant to the needs of seniors.
That being said, you don’t want to jump at the first plan you come across. You need to compare not only the plans but the prices and provider reputations. That could take days of searching through websites, making phone calls, and stressing over what coverage you should go with. This can be very taxing, and sometimes, overwhelming.
Make sure you know what you need to be covered as far as medical services go, then reach out to us. We offer a free, obligation-free tool to help you compare Medicare Advantage plans, prices, and companies. The insurance companies we provide information on are all trusted companies with fine reputations. We have an experienced team standing by to help you make an informed decision.