Medicare Coverage (continued)

Medicare Part C: Medicare Advantage Plans

Formerly known as Medicare+Choice, Medicare Advantage plans are alternatives to the original Medicare plan and are notthe same as "suplemental insurance". Sometimes called Part C or "MA plans", these plans are run by private companies and are part of the medicare program. For many people, Medicare Advantage plans are a good value because they can offer health benefits at low or no additional monthly plan premium beyond the Medicare Part B.

Basically, Medicare pays an amount of money for your health care into these private medicare Advantage plans every month. In return, these plans must provide all of your Part A and Part B benefits, and they must cover at least all of the medically necessary services that the original Medicare plan provides.

MA plans can change different co-payments, co-insurance and deductibles for their services and generally have set provider networks. This means you will likely be limited to seeing those doctors (Primary Care Physician - PCP) who belong to the plan, going to certain hospitals for covered services and getting referrals to see Specialists. If you use providers who aren't in the netwaork, you may have to pay the entire cost of the services rendered. However, MA plans can offer extra benefits, such as vision, hearing, dental, and health and wellness programs. Most include medicare Part D, prescription drug coverage (usually for an extra cost).

Mmedicare Advantage plans come in several forms: HMOs, PPOs and SNP - are often referred to as " coodinated care" plans.These plans are build on the ideas of doctors and hospitals working together to coordinate and faclitate your care. Each plan create its own network.

1. HMO (Health Maintenance Organizations) plans - Your PCP may oversee your care and, in some cases, refer you to specialists as necessary.
2. PPO (Preferred Provider Organizations) plans - generally provide more flexibility to let you choose your doctors and hospitals. These plans typically don't require you to have a referral to se specialist, and you can see doctors outside the network without having to pay the entire cost yourself. If you do visit a doctor or hospital outside the network, though, you'll usually pay a larger share of the cost of your care.
3. SNP (Special Needs Plans) offer individual attention for people with complex health needs. These plans are designed to serve people with special needs like those living in nursing homes, those with chronic conditions such as Diabetes, COPD, CVD , Arthritis, Dementia - those who qualify for both Medicare and Medicaid.
4. PFFS( Private Fee-For-Services) Plans - will allow you go to any doctor if the doctor agrees to accept the plan's term of payment before treating you. It's important to confirm the doctor's agreement. Otherwise, you may have to pay up the full amount of the cost of your care.

It's very important to call any plan before joining to find out what your services will cost and to make sure that a plan will meet your needs. To enroll in medicare Advantage plan, send to me your contact info, I will send to you the application or simply get you enrolled by telephone or online. Be aware that there are limitations as to when you can join, switch or drop a MA plan.

Remember, when you join a Medicare, you will have to provide your medicare Number from your Medicare card and the date your Part A and Part B coverage started. You will also generally still pay the monthly Part B premium along with MA plan's premium (if any). That include coverage for Part A and Part B benefits, prescription drug coverage (Part D, if offered) and any other extra benefits.

Remember