What is a Medicare Advantage Plan? |
Medicare Advantage plans are offered by private companies that contract with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan.
- Some Medicare Advantage plans include Prescription coverage so you don't have to purchase a separate policy.
- There are different types of Advantage Plans, including HMO, PPO, etc.
- You must live in a plan's service area to be eligible for coverage and you can only join and leave Advantage plans at specific times each year.
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What are some of the differences between Medicare Supplements and Medicare Advantage Plans? |
- Medicare Supplements typically have a higher monthly cost; a supplement like Plan G will generally result in almost no other out of pocket costs (after the Part B deductible which is $240 in 2024) for Hospital and Medical bills. It's more of a "pay upfront" type of model.
- Medicare Advantage Plans have lower monthly premiums, some even cost $0/mo, but then may include copays / coinsurance for Dr. Visits, Emergency Room, and Hospitalization. All plans include a Max Out of Pocket Limit to limit your exposure to high bills. It's more of a "pay as you go" model.
- Medicare Advantage plans often use PPO or HMO doctor networks that you must use to be covered or save more money. Medicare Supplements don't have a network and can be used anywhere, all over the country, as long as the provider works with Original Medicare.
- Outside of Guarantee Issue periods, Medicare Supplements are medically underwritten and you can join or leave plans whenever you like (as long as you can pass medical underwriting). There is no medical underwriting to join Medicare Advantage plans (however, if you have ESRD you are ineligible) but you can only join or leave advantage plans at certain times of the year.
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How do I know whether a Supplement or Advantage plan would be best for me? |
- Give us a call and we can do a needs analysis to determine which plan type would be most beneficial for you. It is also very important to go over the rules associated with Original Medicare, Supplements, and Advantage plans. Timing matters with Medicare, and if you don't choose a plan within specific timelines you can be locked out for a while or be subject to penalties.
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CMS Mandatory Disclaimer: |
- We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
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