Medicare Part C (Medicare Advantage Plans) are medicare health plans offered by insurance companies approved by the government.
Medicare Advantage plans are not supplemental insurance, but rather health insurance plans of their own. If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental.
Medicare Advantage Plans must provide coverage that as good or better as the standards set by the original Medicare program, but they offer very different coverage. Here are a few examples of Medicare Advantage Plans:
HMO Plans: These plans require members to pick a primary physician, authorized to act as a mediator for your medical services. Primary Care Physicians (PCP) are general practitioners, family doctors or pediatricians. When your primary physician decides you need to visit a specialist her or she will give you a referral. Only specialists that operate in your network are covered by your insurance plan. Their best attribute is that HMOs provide general care at comparatively lower cost. Certain treatment are somewhat less likely to be covered under an HMO because the goal of this type of insurance plan is maintenance.
Point-of-Service (HMO-POS): HMO plans are helpful if you need to get some medical services out-of-network. In plans like this, you won’t have a primary physician, but you may pay larger fees.
(PPO) Plans: Preferred Provider Organizations operate as a network like HMOs, but are generally more flexible. You may visit an out of network provider if the insurance company has not negotiated prices with the provider already. You may be subject to additional fees and co-insurance, or you may need to pay for the treatment yourself and get reimbursed. With PPOs, you there is not a primary physician and no need to receive referrals for special medical services.
Private Fee For Service Plans Plans: Medicare doles out a certain amount of money to your insurance company on a monthly basis. Its up to your insurance company how to determine the cost of your service. These plans are sometimes only available in specific areas of the country, based on the company that is providing the coverage.
SNP: Medicare Special Needs Plans for individuals are plans where certain chronic diseases exist and the patients have persistent special needs. These plans are designed for people who require more Medicare coverage for their specialized needs.
MSA Plans: Combines high deductible health insurance with a private account at your bank. Medicare funds are regularly deposited into your private account (almost always less than the deductible). You are approved to use these funds to pay for health care throughout the year, as the need arises.
Medicare Advantage Coverage Statistics:
Enrollment for Medicare Advantage (Part C) grew from 5.4 million in 2005 to 8.2 million in 2007
As of 2008, 19% of Medicare beneficiaries received Medicare Advantage coverage
1/3 of Medicare Part D beneficiaries enrolled as part of Medicare Advantage
Nearly half (48%) of Medicare Advantage beneficiaries have a household income of less than $20,000
With so many options to choose from, it may be helpful to talk to a medicare specialist. Medicare in Texas and Medicare in Wisconsin can vary greatly, so depending on your location, speak to a Medicare specialist in your area.
Want to find out more about Medicare and Medicare Advantage Plans?, then visit Jason Milz’s site on how to choose the best Wisconsin Medicare Plans for your special needs.