What is Medicare Advantage?
Medicare has designed several plans for seniors. One of these plans is Medicare Advantage. But what is Medicare Advantage? It is an extensive health insurance plan that you can only access through private insurance providers. Medicare does not sell the plans but it oversees them. Private insurance companies determine the rates they can charge for the plans they wish to sell. They are not obligated to offer all MA plans.
You can find several Advantage plans, making it difficult to choose the right plan for your situation. And this is why we created this page to assist you in better understanding how Advantage plans will cover you. From that information, you can determine whether or not you will need this kind of health plan.
How Medicare Advantage will Provide Coverage?
Medicare regulates the Advantage plans. It also ensures that every provider will include the standard or basic coverage on every plan. In that case, no matter where you purchase the plan, you will get a base coverage. Insurance providers can’t alter this basic scope.
The base coverage will handle Medicare Parts A and B. These expenses would inpatient and outpatient care, like blood usage, doctor’s office visits, and medical tests, among others.
It covers nearly all expenses of Parts A and B, except for the hospice care coverage. You can obtain it from Original Medicare. It is one of the reasons you will need active Original Medicare. In that case, your insurance provider where you purchase the Advantage plan will give you most of the coverage for Parts A and B.
Apart from Part A and B medical expenses, MA will also include emergency medical services and urgently needed medical care. In that case, you will have coverage for ER, ambulance transport and other treatments. Urgently needed medical care services would include surgery, medication and medical tests, among others. They are considered services that can help you maintain your good health.
Medicare Supplement Plans 2021
Comprehensive Coverage of MA
There are different Advantage plans that you can choose from. Many of them will include not just basic coverage but also other medical expenses. A lot of MA plans will give you high coverage.
High-priced plans are powerful plans. Most of them include Part D. It is a prescription program that you can either purchase on your own or included in your Advantage plan. Regardless of how you obtain Part D, this plan can help lower your prescription medication costs.
It can pay for brand name and generic drugs. With this type of health plan, you can significantly lower your overall medication costs. It means that you will pay little out of pocket expenses for your medicines.
However, Part D does not cover all medications. It can give you more coverage for common medications. It also provides more coverage for cheaper, generic drugs.
Expensive drugs are still covered but only partially. If you are using expensive, rare drugs, though, then don’t expect that Part D will cover it.
Another comprehensive Advantage plan you can purchase will include routine checkup coverage. With this type of plan, any cost related to your trips to the dentist, optometrist, or general health practitioner will be covered.
You can also obtain a plan that covers your dental cleanings, medical tests, a new pair of eyeglasses or hearing aid. However, all of these are covered if they are prescribed by your doctors.
What is the Medicare Advantage Plan and How to Enroll?
You need to meet the requirements of Medicare Advantage plans before you can sign up for one of them. These plans are only available for seniors.
If you are 65 years old or older, then you are qualified to obtain an Advantage plan. However, you must have active Original Medicare to enroll in one of the plans. You may qualify even if you are not yet 65. It happens if you have a certain type of disability.
It is vital to remember that Medicare doesn’t allow any conflicting coverage. It means that you have plans that give coverage for the same medical expenses at the same time.
For instance, Advantage and Supplement plans can provide the same coverage. That’s why you can’t have both an Advantage plan and a Supplement plan at the same time. You need to choose one over the other but you can’t have both.
You can apply for one of the Advantage plans around your 65th birthday. Medicare lets you enroll three months before or after turning 65. This is your initial enrollment period. You must take this opportunity to enroll because you can get lower rates for the plans.
If you missed it, though, you can enroll during the open enrollment period. It starts on October 15th and ends on December 7th. This open enrollment period happens every year. If you choose to get coverage on this period, your coverage will start on the first day of the following year.
Who Sells Medicare Advantage?
There are various insurance providers that sell this type of plan. You can only purchase it from private insurers. You need to request quotes for these plans to known which insurance providers are selling them in your area.
Among the insurance providers that sell MA plans would include Aetna, Humana, Blue Cross Blue Shield, United Healthcare and Cigna. But these are not the only insurers that sell these plans in your area. If you wish to know the other companies, please use our site to request quotes.
Although Advantage plans are useful for many seniors, you cannot use them anywhere in the US. Keep in mind that the plan is limited by the network. The kind of plan will determine the coverage you can get.
For the HMO Advantage plan, you can get full coverage only if you stay within the network. Going off-network will not give you any coverage at all. But if you pick a PPO plan, then you will get partial coverage if you go outside the network. Full coverage is given if you stay within the network.
If you are still wondering what is Medicare Advantage and how it affects your coverage, then consider talking to our health insurance experts. Or you may use our free tool to get a list of quotes from various insurance providers.