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senior medicare plans

What is Medicare Advantage?

A Medicare Advantage Plan, in general, is similar to an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization). Most of these plans require you to use the providers in their network, except emergency care, out-of-area urgent care, or out-of-area dialysis).

Medicare Advantage Plans are offered by private companies approved by Medicare. You will get your Part A (hospital insurance) and Part B (medical insurance) coverage from the Medicare Advantage Plan and not original Medicare.

These plans must cover all of the services that original Medicare covers except hospice care. In the case of hospice care, original Medicare covers it even if you’re in a Medicare Advantage Plan. These plans are NOT supplemental coverage.

Medicare Advantage Plans may offer extra coverage that original Medicare does not cover, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Plan, but not always.

You want to be sure and understand all the different aspects of each plan you are considering before making a final decision, as there are many variations in these plans. You may want to view the Medicare Plan Finder to find plans in your area. Remember the benefits are the same when comparing plan to plan. For instance, Plan G with one company is the same as Plan G with another company, even though the premiums differ.

If you are in a Medicare plan, review the EOC (Evidence of Coverage) and ANOC (Annual Notice of Change) your plan sends you each fall. The EOC gives details about what the plan covers, how much you pay, etc. The ANOC includes any changes in coverage, costs, or service area that will be effective in January. If you don’t get these important documents, contact your plan, because any changes must be made from October 15 to December 7, unless there are special circumstances such as moving out of the plan’s service area, obtaining Medicaid, moving to an institution (like a nursing home).

What is Medigap?

Medicare supplement insurance policies are called Medigap policies.

Original Medicare pays for many, but not all, health care services and supplies. A Medicare supplement policy, sold by private companies, can help pay some of the health care costs that original Medicare doesn’t cover, such as co-payments, co-insurance, and deductibles.

Some Medigap policies also offer coverage for services that original Medicare does not cover, like medical care when you travel outside the U.S.

Every Medigap policy must follow Federal and State laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Companies can sell you only a “standardized” policy, identified in most states by the letters A-N. All policies offer the same basic benefits, but some offer additional benefits, so you can choose which one meets your needs.

Note: Plans E, H, I, and J are no longer available for purchase, but if you already have one of those policies, you can keep it. Contact your insurance company for more information.

You have to pay the premiums for a Medigap Policy. Different insurance companies may charge different premiums for the same exact policy! That’s why it’s imperative that you seek the assistance of a reputable private insurance agency such as Senior Savings Network for all your Medicare supplement information and rates. Another great resource for Medicare are our friends at BoomerBenefits.com.

Medicare Advantage Plan Options

Choosing between Medicare Supplement and Medicare Advantage

Considering a Medicare Advantage Plan to save money?

Consider this…

The clients we help are usually on a FIXED INCOME.

This means that our senior clients do not like SURPRISES with their health plan.

As you can see, with a Medicare Supplement policy, you have consistent monthly premiums.

With a Medicare Advantage Plan, you could have a BIG surprise when you need hospital services.

Avoid the red line that’s possible with Medicare Advantage.

Example includes Part B premium, four day hospital stay, outpatient procedure and doctor visits.

 

Compare Medicare Supplements to Medicare Advantage Plans:

Concerns of Seniors: Medicare
Supplement
Medicare
Advantage
Restrictive Network of doctors and hospitals NO YES
Co-Payments to Providers NO YES
Up to $3,000 yearly
Out of Pocket Costs
NO YES
Health Plan Decides What Test and Procedures Are Approved For You NO YES
Can Your Plan
Be Cancelled?
NO

Cannot be cancelled as long as premiums are paid
YESPlans are approved yearly and can be dropped.
Ability to Travel the Country and Use Any Doctor or Hospital YES NO
Is Pre-Certification Required for some Treatments? NO YES

Penalties apply if pre-cert not done.

MD Anderson Cancer

Treatment Center Included?

MAYO Clinic Included?

YES 

YES

NO 

NO

 

Watch These Short Videos.
Things your agent won’t tell you:

 

Good Morning America on Medicare Advantage.

Click on the video to start playback:

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A Doctor Discusses Medicare Advantage.

Click the video to start playback:

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President Obama’s Changes to Medicare Advantage:
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    Please let us help you find the best plan for your situation.

Click here to get Medicare help.