The majority of US citizens above the age of 65 have Medicare plans. This is insurance against the cost of medical treatment. But Medicare only covers two major parts. These parts are usually referred to as part A and part B. Medicare part A covers in-patient treatments, which are costs of hospitalization, skilled nursing after three days of hospital admission, and hospice services. These services, however, do not include admission for custodial services. Medicare part B covers out-patient treatment. This includes an outpatient visit to the hospital, cost of an ambulance ride, administration of prescription drugs, X-Rays, and other radiography. It may also cover the cost of check-ups to some extent.
However, the original Medicare does not cover part C and part D of the scheme. Medicare part C includes ear treatment and other audiology, eye treatment, eyeglasses, and lenses as well as proper and regular check-ups. It also includes emergency treatments and the cost of treatment in the emergency room. All these are not in the original Medicare plan. Also, note in the original Medicare plan is the Medicare part D. This is the cost of prescription drugs, majorly the self-administered ones. The cost of part C and Part D are out of pocket costs for Medicare Plan subscribers, and this cost may be so high that many people may not be able to afford them. To reduce the burden of these out of pocket costs, private medical insurance companies are given license to cover these costs. This special plan is called the Medicare Advantage Plan.
Therefore Medicare Advantage Plan is medical insurance by private companies that covers the out of the pocket cost of the original Medicare.
What exactly does it cover?
It is important to note that everything covered by the Original Medicare Plan is also in the advantage plan. Therefore, Medicare Advantage Plan covers part A, Part B, Part C, and Part D of the Medicare scheme. It includes all inpatient and outpatient costs, emergency cost, cost of hearing aids, and sight aids. It also includes regular check-ups and in most cases, admission to the gym club. Medical Advantage Plan includes the cost of prescription drugs, the self-administered drugs as well as professionally administered drugs and the cost of administering them.
Part A and part B of Medicare plan also come with deductibles. These are the payment you made yourself before you can claim. Some also have co-payments. But most advantage plans cover these deductibles and copayment.
Since it is from private insurers, it is flexible. An individual buying the insurance is free to select what he wants to include in his plan and what he does not want. That is what will decide the monthly premium. You should also note that some insurers do not include all the coverage in their plan. Therefore, it is necessary to study what each insurer offers and only buy from an insurer that has everything you want.
Who is it for?
Medicare Advantage Plan is primarily for US citizens that are above the age of 65. But it is also available to people under the age of 65 if they have serious medical problems. The medical issue for people under the age of 65 to qualify for enrolment in Medicare Plan includes end-stage renal diseases as well as ALS. Those under the age of 65 who are declared by the Social Security Administration as being disabled can also apply for the plan.
How can I enroll?
The best time to apply for the Medical advantage Plan is between the 15th of October and the 7th of December every year. If you are above 65 and you apply during this window you have a very high chance of being granted the particular plan that you desire. That does not mean you cannot enrol outside the window period, it only means that your chances may be low when you apply outside the enrolment window. Nevertheless, if you are denied, just wait for the next window to open and reapply.
To apply for this plan, you must be a citizen of the United States of America and either be above the age of 65 or have disabilities that qualify you for the plan. Not everybody with a disability however qualifies. If you want to apply on the ground of disability, it is, therefore, necessary to check with an agent of Medicare plan whether you qualify or not.
Also, your enrollment for Medicare Plan will not affect your qualification for Medicare Advantage plan. Whether you have a Medicare plan or you don’t have, you can always apply for the advantage plan. Remember that everything in the ordinary Medicare plan is also in the advantage plan. And your chances of getting approval do not depend on your medical condition, especially if you apply as you are clocking 65.
How much does it cost?
The cost of the Medical Advantage Plan depends on many factors. The most important factor is the benefits and treatments that you want to be in your plan. The more things you want, the higher your cost. Another factor is your work history. Whether you worked and were paying tax or not will also count when calculating your premium. An individual who worked and paid tax for at least ten years will pay a lesser amount than the one who does not satisfy the same condition. For this reason, it is necessary to seek a piece of advice from a Medicare Advantage Plan agent to know which medical cost you may not need to pay for on the ground of your tax, and which plan will just work best for you, before you purchase one.
As you should know, since the Medicare Advantage Plan is sold by private companies, each company decides its price. The price of a particular plan will vary from company to company, even if the services are the same. That is the reason you must compare plans before you buy Medicare Advantage Plan.
This website has tools that you can use to compare prices of the plans available from different private insurers. With these tools, you can easily and quickly determine which company is the cheapest for the particular plan you wish to buy. That will save you the effort of visiting companies to compare prices. All you have to do is to answer the question “What is Medicare Advantage?” It will give you what Medical Advantage does and allows you to compare prices among different companies that sell the advantage plan.
What if I have another plan?
You may have purchased another insurance plan and are wondering if you can still purchase Medicare Advantage Plan with it. The answer is both yes and no. Some insurance policies can work very well with Medicare Advantage Plan while some policies cannot. There is no point in having two policies that cover the same thing. Therefore if the policy you have before is also in the Medicare Advantage plan, it will be advisable that you drop the policy before you purchase the Medical Advantage Plan. A common example is Medicare part D, which covers the cost of prescription drugs. This cost is also in most of the Medical Advantage plan. Therefore it will be a waste of money to purchase both. If you want to buy Medicare Advantage Plan, and you have Medicare part D, then it’s time to give up Medicare part D.
Another policy that is not advisable to purchase with Medicare Advantage Plan is a Medicare Supplement Plan. Everything in the Supplement Plan has already been included in the Advantage Plan. Hence if you have both, you must give up one, and that one should be the Supplement Plan.
Sometimes your union or your employer may also have policies that have already covered everything in the Medicare Advantage plan. Therefore, if you have such policies, it will be better to check properly before you purchase Medicare Advantage Plan, to avoid paying unnecessary premiums.
Consider your provider’s network
Not every hospital accepts Medical Advantage Plan. Each company selling insurance has a network of hospitals and health givers that recognize their policy. Hence, the fact that you have a Medical Advantage Plan does not mean you can walk to any hospital and use your plan. You need to know the list of health givers that accept insurance plans from your insurer before you buy a plan from them.
By definition, those health givers – hospitals, clinics, medical practitioners, and other medical bodies- that accept covers from a particular insurer are regarded as the insurer’s network. If you have a plan with an insurer and you use a medical facility in the network of the insurer, then you will be covered. But if you use a medical facility that is not in the network of the insurer, then you may not be covered. But this also depends on whether your plan is PPO or HMO
Both PPO and HMO cover everything in your plan fully when you use a medical facility that is in the network of your plan provider. However, HMO does not cover you when you use a facility that is not in the network of your insurer. As for PPO, it offers partial coverage. It means if you purchase PPO, anywhere you seek medical service that is included in your plan, you will get some coverage. You will get full coverage if it is in the network and partial coverage if it is outside the network. Partial coverage means you will have to pay some amount from your pocket. Based on this, PPO is always more expensive than HMO.
Companies that sell Medicare advantage plan
Medicare Advantage Plan can only be purchased from private insurers. Although their plans are constantly being checked by the Medicare Scheme for regulation, many private companies are selling this plan and their offers vary. Below is a list of popular companies that have approval from the Medicare to sell advantage plan:
- Mutual of Omaha
AARP is a well-known name in the industry. They had to be in the business of providing medical insurance, especially to the old people for a long time. Their other plans include healthy living plans and assisted living plans. They also give financial advice to elderly people. All of their plans come with a lot of benefits. They also have a very good reputation among their clients. Because of the wide scope of their coverage, it won’t be a problem for anybody to see an advantage plan that properly suits his need.
Humana is another private health insurance provider that offers a wide range of policies. Their staff are hardworking and they are professionals. Their Medicare Advantage Plan has many benefits and there are many options for you with them to choose from.
Mutual of Omaha
When we talk about insurers that have a good reputation, Mutual of Omaha should come to mind. Everybody knows them for their perfect services. They also have well informed, friendly, and professional customer relations services. If you are thinking of buying an advantage plan, Mutual of Omaha should be among the first to consider.
For many years, people have known Cigna. They have been helping many to overcome the burden of their health situation. Cigna is also popular for making their services available over different devices. This will make you to constantly be in touch with your providers. They are a reliable provider of Medicare Advantage and they have many choices in their plans. You certainly need to consider one of their options if you need this plan.
You can get the best deal
Medicare advantage plans for 2021 will save you a lot of out of pocket costs and enables you to enjoy good medical care. At an old age, you won’t want anything less. But to take full advantage of this plan, you must get the best deal. Everybody knows the only way to get the best plan is to compare plans. Comparison is not only about the cost but also about the services as well as other benefits that come with the plan.
Our website is here to assist you in making this comparison. With the tools and information available on our website, you no longer need to keep searching for the Medicare Advantage Plan. We have everything you may need to make the best choice so that you can enjoy a good health plan at the best price. Why not take advantage of our website and save money and stress.