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What is a Medicare Advantage Plan? Take a Few of These Facts and Call Us in the Morning

by EINSURANCE

What is Medicare Advantage Plan and how can it benefit you? Have a seat in the waiting room and Doctor EInsurance will be with you shortly to explain everything.

 

 

What Is Medicare Advantage? Make an Appointment for the Facts and Get Well Soon

 

“Keep the Government Out of My Medicare!” The sign the earnest senior woman was holding at a town hall meeting a few years ago points out the problem. You'd have to be somewhat hard of hearing to miss the Great American Healthcare Debate that has captivated the nation these recent years. But most casual observers don't know the basic terms of the debate, let alone that facts are often hidden behind myths, or in a 2,000-page law that no one bothered to read. Words like “government-run,” “single payer,” “for-profit,” and “Medicare as we know it” get tossed around tonsils like so many splintery tongue depressors that no one is really sure what's been proposed and what's been debunked.

 

And now that many important provisions of the Affordable Care Act (Obamacare) will soon take effect, many wonder how long-standing government programs like Medicare will be affected. As most of the ACA's key provisions have not yet been implemented, it is impossible to say exactly how the law will affect Medicare overall. What we can say is that the ACA does repurpose millions of Medicare dollars going to service providers to cover other costs, so the incentive for health providers to care for patients on Medicare will not increase.

 

 

Medicare Advantage Is Government-Run in Partnership with Private Insurers

 

This means that popular Medicare programs like Medicare Advantage, also known as Medicare Part C, will continue to be available. Unlike traditional Medicare in which claims and payments get processed by the Centers for Medicare and Medicaid Services (CMS), Medicare Advantage plans are processed and managed by private insurance companies, or Medicare Advantage Organizations (MAOs). In short, Medicare Advantage is Medicare provided through a different stethoscope.

 

Instead of Uncle Doctor Sam, different kinds of healthcare organizations provide Medicare Advantage plans that the government regulates in different ways. Medical Savings Account Plans (MSAs) also hold court in the Medicare Advantage waiting room. Medicare Advantage Plans come in the following four flavors: Health Management Organizations (HMOs), Preferred Provider Organizations, Private Pay-for-Service Plans, and Special Needs Plans. Each of these plans has certain regulations, but the idea is to provide additional coverage, such as dental care and wellness programs, not included in the original Medicare.

 

Each Medicare Advantage plan offers different types of services and varied payment tiers. Some plans charge monthly premiums while others charge annual premiums. Some cover all Part B expenses while others require higher deductibles. Some allow you to see only doctors in the plan, while in others; you need to choose a primary care physician.

 

 

Doctor Choice

Prescription

Coverage

Primary Doctor

Referrals Needed

Notes

HMOs

No

Yes

Yes

Yes

 

PPOs

Yes

Yes

No

No

Pay extra for extras

PFFSs

Yes

Maybe

No

No

Must negotiate with doctors & pay high co-pays

SNPs

No

Yes

Yes

Yes

Limited to certain pre-existing conditions

 

Find Out More About Medicare Advantage Plans and How the AFC Might Affect Your Health Insurance

 

Keeping up with the latest healthcare reforms and changes is enough to make you want to see a doctor. EInsurance can ease your pain with free quotes and straightforward answers. 

Einsurance.com answers your questions about Medicare Advantage Plans. Visit our Website today for more information and a free insurance quote.

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