What is Medicare Advantage?

Information You Need If You’re Eligible for Medicaid

A lot of people have been asking, “What is Medicare Advantage?”

Medicare Advantage Plans (Medicare Part C) are optional Medicare plans offered by Medicare-approved private companies and available to people already enrolled in Medicare Part A (hospital) and Medicare Part B (medical). If you enroll in a Medicare Advantage Plan, your plan will provide all of your Medicare Part A and Part B coverage.

Medicare Advantage plans can provide also additional coverage in other areas of health including dental, vision, and hearing. Most Medicare Advantage plans also include prescription drug coverage (Medicare Part D).

Medicare Advantage Plans include:

Medicare Private Fee-for-Service (PFFS) Plans

Which generally allow you to visit any doctor or hospital Original Medicare would allow you to visit, as long as the doctor or hospital agrees to treat you.

Health Maintenance Organization (HMO) Plans

Which normally require referrals from primary care physicians and treatment by specialists and hospitals within the plan’s network.

HMO Point of Service (HMOPOS) Plans

Which are HMO plans that may allow you to get some services out-of-network for a higher cost.

Medicare Preferred Provider Organization (PPO) Plans

Which allow you to use doctors, hospitals, and providers outside the plan’s network at additional cost; and

Medicare Medical Savings Account (MSA) Plans

Which deposit Medicare funds into an account used for paying your health care costs.

If you’re eligible for both Medicaid and Medicare, you’re able to enroll in a Medicare Special Needs Plan (SNP). SNPs are designed to provide focused, specialized health care for specific groups of people including beneficiaries of both Medicare and Medicaid. As with all other Medicare Advantage Plans, a Special Needs Plan will provide all your Medicare Part A and Part B coverage. SNPs are also required to provide prescription drug coverage.­
For more information about Medicare Special Needs Plans, click here.

You can enroll in a Medicare Special Needs Plan or another Medicare Advantage Plan of your choice even if you have a preexisting condition (except End-Stage Renal Disease). As with Original Medicare, you will retain your Medicare rights and protections, including the right to appeal.

Not all Medicare Advantage Plans work the same way, and Medicare Advantage costs can vary widely, so it’s important to investigate all the plans available in your area before making a choice. To learn what plans are available in your area, click here.

If you’d like to know more about how to join Medicare Advantage, contact MedicareMall now and one of our licensed, bonded representatives will be glad to give you the information you need and help you determine which plan is right for you.

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