Medicare Advantage
Medicare Advantage is quickly becoming popular because of the extra benefits that are offered such as extra days in the hospital, cheap out-of-pocket costs for doctor visits and low-cost prescriptions.
These plans are offered throughout the United States through private insurers. Part A and Part B of Medicare is required to join the plan and Medicare’s Part B premium must be paid by the Medicare recipient in order to enroll. Private insurers offer policies that have varying co-payments and premiums that may start as low as $0.00 per month.
A Medicare Private Fee for Service or (PFFS) Advantage Plan is exploding with members because it allows the Medicare recipient to visit any doctor in any hospital in the United States. The Medicare PFFS Advantage Plan is the current superior value versus the traditional Medicare Supplement Plans for most people.
The Health Maintenance Organization or HMO Advantage Plan continues to be a favorite for those who desire minimal out-of-pocket expenses and extremely low monthly premiums.
Medicare Advantage in a nutshell:
- Medicare Advantage plans are available with little or $0.00 monthly premiums.
- Medicare Advantage plan holders are still on Medicare and retain the rights and protections of Medicare.
- A Medicare Advantage member will continue to receive regular Medicare-covered services. In addition, a Medicare Advantage plan holder will also have access to additional services that neither Medicare supplements nor the original Medicare providers.
- Most prescription drugs are included in Medicare Advantage, while supplemental Medicare policyholders must pay extra for Part D.
- Medicare Advantage plans are now being offered to 98% of the counties in the USA.
- Supplemental Medicare policyholders must pay their monthly premium whether sick or not. Medicare Advantage plans have the policyholders make a small co-payment for doctor visits and a somewhat larger co-payment for hospital visits.
- The Medicare recipient should know that Medicare Advantage guarantees that even in a time of poor health there is a maximum out of pocket expense. A Medicare Supplement policy guarantees the Medicare recipient to spend $1,600 to $2,000 a year even if you never go to the doctor.
- A primary physician (PCP) referral to see a specialist is no longer required. A PFFS or PPO Medicare Advantage plan permits the policyholder to go to any doctor or hospital with no referrals!
- End Stage Renal Disease (kidney failure) can even qualify for the advantages of a Medicare Advantage plan. In some counties, we even have companies specifically people with an end-stage renal disease.
Important: You may only be able to buy Medicare Advantage plans that have prescription drug benefits within 6 months from the first date of Medicare Part B. After 6 months, your choice of plans may be limited.
What You Need to Enroll for Medicare Advantage
You will need your Primary Care Physician’s name and ID number to enroll. To find this information, you will need to call your primary care physician.
You will also need information found on your Medicare card (example shown below):
Medicare Claim Number
Hospital (Part A) Effective Date
Medical (Part B) Effective Date
