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:
Health Maintenance Plans: Plans of this type require patients to pick a PCP, or primary care physician, which is the only doctor which can refer you to other medical services. Primary Care Physicians (PCP) are usually general practitioners, family doctors or pediatricians. When your PCP refers you to a specialist, it is almost always a doctor within your network. This is because only specialists that in your network will be covered by an HMO. HMOs provide general care at comparatively lower cost because certain, more expensive, treatments are less likely to be covered. The goal of this type of insurance plan is exclusively maintenance.
HMO Point-of-Service (HMO-POS) Plans: An HMO plan that may allow you to get some services out-of-network for a higher cost. You also do not have to select a primary physician.
(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.
Special Needs Plans (SNP): Medicare Special Needs Plans are for individuals with certain chronic diseases or conditions and therefore have special needs. These plans were designed to give people with special needs better access to Medicare for specialized care.
Medical Savings Account Plans: MSA's are high deductible health plans attached to a bank account. Medicare gives you money through your MSA account, though usually a smaller amount than your deductible. Health care services throughout the year are paid for through your MSA account.
Medicare Advantage Coverage Statistics:
Enrollment in Medicare Advantage Plans increased 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 Part D beneficiaries are enrolled in a Medicare Advantage Plan
It is interesting to note that almost half (48%) of the people receiving Medicare Advantage coverage have an income of less than $20,000
There are many options and it is definitely a good idea to speak with a specialist in the Medicare industry. Medicare can differ greatly between states like Texas and Wisconsin, so speak to a Medicare specialist in your area.
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:
Health Maintenance Plans: Plans of this type require patients to pick a PCP, or primary care physician, which is the only doctor which can refer you to other medical services. Primary Care Physicians (PCP) are usually general practitioners, family doctors or pediatricians. When your PCP refers you to a specialist, it is almost always a doctor within your network. This is because only specialists that in your network will be covered by an HMO. HMOs provide general care at comparatively lower cost because certain, more expensive, treatments are less likely to be covered. The goal of this type of insurance plan is exclusively maintenance.
HMO Point-of-Service (HMO-POS) Plans: An HMO plan that may allow you to get some services out-of-network for a higher cost. You also do not have to select a primary physician.
(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.
Special Needs Plans (SNP): Medicare Special Needs Plans are for individuals with certain chronic diseases or conditions and therefore have special needs. These plans were designed to give people with special needs better access to Medicare for specialized care.
Medical Savings Account Plans: MSA's are high deductible health plans attached to a bank account. Medicare gives you money through your MSA account, though usually a smaller amount than your deductible. Health care services throughout the year are paid for through your MSA account.
Medicare Advantage Coverage Statistics:
Enrollment in Medicare Advantage Plans increased 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 Part D beneficiaries are enrolled in a Medicare Advantage Plan
It is interesting to note that almost half (48%) of the people receiving Medicare Advantage coverage have an income of less than $20,000
There are many options and it is definitely a good idea to speak with a specialist in the Medicare industry. Medicare can differ greatly between states like Texas and Wisconsin, so speak to a Medicare specialist in your area.
About the Author:
Learn more about Medicare and Medicare Advantage Plans. Stop by Jason Milz's site where you can find out all about Wisconsin Medicare Insurance.
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