Medicare Advantage Plans

Original Medicare coverage plans can become a bit complex and there may be costs when you need certain services. Medicare Part C, also known as Medicare Advantage plans, are offered by private insurance companies and the coverage  includes Part A and Part B, plus additional benefits. This means that hospital insurance and medical insurance are included. Some plans may include prescription drug coverage. They provide prescription drug and health care benefits within a single healthcare plan instead of a stand-alone plan. In many areas there are several cost-effective options to choose from and additional unique benefits not included in Original Medicare.

Learn how a Medicare Part C Plan can work for you. As an alternative to Part A and Part B, Part C helps you gain the benefits of both programs.

If you have additional questions not addressed in the following article, contact one of our licensed agents who can help you get started on your Medicare Part C Plan. Contact the insurance professionals of McCunis-Fox today to review your options…

Comparison of

Medicare Plans

Medicare Advantage and Medicare Part C are considered the same program. Many include the convenience of having both the drug benefits and health facility care coverage within a single plan. Depending on your needs and preferences, this  may be a better alternative for you than the option of enrolling into a Medicare Prescription Drug Plan, which is an entirely different program for the purpose of covering prescription drugs. There may also be extra benefits included, such as dental coverage, health wellness programs, and routine hearing and vision check-ups, depending on the plan details. These are benefits Original Medicare does not include. Medicare Advantage plans are offered by private insurance companies. All of these companies are contracted with Medicare. The Medicare Advantage plans provide most of the same coverage that an Original Medicare plan would cover, Part A and Part B. This doesn’t include hospice care in Part A, however. To be eligible, you must be within the service area of the Medicare Advantage plan you want to enroll in. First, you have to be enrolled in Part A and Part B.

Are There Disadvantages to Medicare Advantage Plans?

While they have great flexibility, they may be pricier than other programs. There is the possibility of unplanned out-of-pocket expenses that can occur. Copay costs may add up over time, depending on your health care needs. The only time you are able to switch back to the Original Medicare plan is during the Medicare Annual Enrollment Period.

The details regarding specific provider and prescription drug coverage when you are traveling depends on the plan.

All enrollees have to follow the rules of the plan to receive coverage. Provider participation in specific plans may change.

Linda Newsome in Houston area has been my health care insurance agent since I retired back 2016 and got on Medicare Part A & B. She helped me decide on the option of Aetna Advantage PPO additional plan which has been great! I'm still on Aetna now in 2020 and will be again 2021. Do your self a favor and let her help you out! Medicare/Social Security have big penalties if you don't get signed up on time! Linda is very quick to get back with you either by email or cell and will come to your house if you make an appointment.

James G.Client since 2016

What are four types of Medicare Advantage plans?

The most common types of Medicare Advantage Plans include the Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), Private Fee-for-Service (PFFS), and Special Needs (SNPs) plans. These are the most common, but not the only kind of plans available as some private insurance companies provide more specialized options for applicants with unique needs.

Preferred Provider Organization

The PPO plan is offered by a private insurance company where there is a network of doctors and hospitals. If you use one of the doctors within this network, it costs less. When you use a doctor outside of the network, it usually costs more. Prescription drugs are typically covered in PPO plans.

Health Maintenance Organization

For an HMO plan, you receive services for providers except when it concerns an out-of-area urgent care service, an out-of-area dialysis, and emergency care. Some coverage plans may include out-of-area services, but it costs less when working with your network of providers. In most cases, prescription drugs are covered in HMO Plans.

Private Fee-for-Service

This plan is offered by a private insurance company but is much different from the Original Medicare plan and Medigap. In this plan, it is pre-determined how much in costs will go to doctors and hospitals, and how much you will pay when you receive care. In some cases, you can see any provider, but the costs will be less if you work with a network provider. You can also go to any Medicare-approved doctor who will accept your payment plan terms. Prescription drugs might be covered, or you can join a Medicare Drug Plan with Part D coverage.

Special Needs Plan

This plan limits membership, and only people with unique diseases or characteristics can join. The drug formularies are more extensive and meet the needs of the individuals covered under these plans. Some SNPs cover services out-of-network and some don’t. All SNPs must provide Medicare drug coverage (Part D).

Get Started on your Medicare Advantage Part C Medical Coverage

To further review your options, you can work with a licensed sales agent who can guide you on the next steps. Review your medical coverage options and find out which is the most cost-effective plan for you. To make the process easier, you can contact McCunis-Fox to get started today.

Speak with an Insurance Agent today!