A Medicare Advantage plan is a special kind of health insurance plan available for people over the age of 65 from private insurance companies, an alternative to the Original Medicare plan’s parts. For a clearer understanding of the Medicare Advantage system, let’s have a look at the Original Medicare program and the components that Advantage plans provide an alternative to and some important features of Medicare Advantage plans.
Things to Know about Original Medicare
Medicare is practically the federal health insurance program for people aged 65 and for people younger than that age who suffer from disabilities or certain illnesses, such as end-stage renal disease. Medicare includes a set of services grouped under so-called Parts. Here is what each Part involves:
- Medicare Part A – this part covers the costs related to hospital stays as well as for care in a skilled nursing facility or in a hospice facility for a certain amount of time. Most people who have Part A insurance do not pay a premium; those who do not qualify for premium-free Part A can choose to buy Part A for a monthly premium;
- Medicare Part B – this part covers for the outpatient services provided in doctor’s offices and for certain preventive services. Part B comes for a premium for everyone. The actual amount to be paid by the beneficiary on a monthly basis is calculated based on the beneficiary’s income;
- Medicare Part D – this part represents the coverage for prescription drugs. The coverage might be complete for some types of prescription medication and partial for others.
Things to Know about Medicare Advantage
As you see, Part C is missing from the list above and that is because Part C is what used to be Medicare + Choice and what is now Medicare Advantage. Advantage plans offer beneficiaries access to the same services as Original Medicare, but they are provided by private insurers and they not only bundle Part A, Part B and usually Part D as well, but they also offer additional coverage, such as visual coverage, hearing aids and dental care.
Medicare Advantage plans being offered by private insurers, they always come for monthly premiums. Those premiums are likely to be higher than Original Medicare premiums, but Advantage plans also include an upper limit for the share to be covered by the patient – a feature that is not available with the Original plans.
Help Available If Needed
Advantage plans are usually available from insurers on a regional basis and they might vary considerably in terms of premiums and conditions. The abundance of features and options available might make the task of putting together the right policy daunting, but fortunately, there is help – through independent Medicare Denver insurance professionals, agents or brokers who can provide expert guidance related to the available options. These insurance professionals can also provide assistance with the paperwork related to enrolling into the program chosen as well as help to meet the deadlines related to the enrollment.