What You Need to Know About Medicare Plans to Make the Right Choice.

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Medicare is a federally funded health insurance plans for people 65 and older and younger people with certain disabilities.   When you enroll in Medicare for the first time, you’re automatically enrolled in this “traditional” program.  However, you have the option of joining a Medicare Advantage Plan.  Choosing a Medicare Advantage Plan can be confusing but here are some tips to guide you:

What is a Medicare Advantage Plan?

Medicare Advantage Plans are hospitalization and medical plans offered by private insurance companies.  Some also offer vision or dental coverage.  Being covered by this type of plan means you are not covered by traditional Medicare but may offer you more flexibility and coverage than traditional Medicare. 

Types of Medicare Advantage Plans.

Medicare Advantage Plans are offered by private insurance companies and there are several types on the market.  There are Health Maintenance Organizations or HMOs.  HMOs have a network and you chose a primary care physician within that network.  You will want to be sure your physician is a part of the network for your HMO plan.  HMOs will deny coverage if treatment is received by a physician not within the network (except in an emergency) or if you do not go through a proper referral for a specialist.   Other types of Medicare Advantage Plans are Preferred Provider Organizations or PPOs.  PPOs are similar to HMOs but have no network.  Although you can see any physician, you want to make sure your physician accepts your PPO plan.   

Premium Costs

Plans vary state by state so coverage under a certain premium may vary.  Each insurance company sets their own rates for premiums.  In some cases you can still required to pay your Medicare Part B premium.  Be sure to ask your insurance agent if the Medicare Advantage Plan you choose covers all or part of the Part B premium.

Out-of-Pocket Costs

Most plans have an annual limit of out of pocket costs.  With Medicare Advantage Plans you have to pay co-payments or have an annual deductible.  Some plans may have additional costs for services such as emergency room visits, lab work, or a private room during a hospital stay. 

Drug Coverage

Some plans have drug benefits. If you are taking a medication, make sure it is covered by your plan and make sure you choose a plan based on the specific medication you take, because plans can charge different co-pays for the same drug.

More information

To get more information about Medicare Advantage Plans, you can go online and get quotes for different premiums, co-payment amounts and annual deductibles and whether your particular medications are covered by a plan.

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