When you become eligible for Medicare, you may be surprised to find that you have options in the type of Medicare you sign up for. Medicare is for citizens who are 65 years old or who have a disability. It provides medical needs such as prescription medication, in or out patient medical services. A program called Medicare Advantage may be able to replace Medicare plans A or B and here is what you need to know about it.
What Medicare Advantage Covers
Medicare Advantage plans are different from Medicare Part A and B by offering both hospital coverage and standard medical insurance. Before this program was introduced, you could choose Part A or B, or in some cases you could pay to have both plans. With Medicare Advantage, you only need the one plan.
You will be covered both when you need in hospital treatment as well as any visits you may need to make to the doctor. Like standard medical insurance policies, you will be covered for emergency room visits as well as urgent medical needs. Lab visits, x-rays, standard medical appointments and some medical equipment are all covered by Medicare Advantage. Some plans offer additional vision and dental services, so if this is important, be sure you verify your new program covers these additional needs.
Different Plans For Different Needs
There are five different Medicare Advantage plans that you can choose from. Each of these have their pros and cons, but the ultimate decision should come down to what it is you need.
- HMO Point-Of-Service plans – For these particular plans, you can get a portion of your medical needs with medical professionals that are not in your service plan. Be prepared though, this plan will have a higher copayment than if you chose a different plan.
- Health Maintenance Organization plans – This plan is very limiting for some people. You can only go to doctors that are associated with this program. You will have to constantly refer to the list of approved medical providers.
- Special Needs Plans – This SNP program is for people who may have a long term disability. People also eligible for the Special Needs Plan include those who live in a nursing home and have both Medicare and Medicaid.
- Private Fee For Service Plans – For this plan, you can go to any medical professional you want. However, the doctor must approve your insurance. The Private Fee For Service Plan has a set amount they are willing to pay for services. While this may seem freeing, it means verifying every procedure and its fees before you decide to proceed.
- Preferred Provider Organization – This is a fairly simple plan. If you choose to use people that are in network, your copayment will be lower. If you choose to go out of network, this is allowed, but be prepared to pay a higher fee.
No matter which plan you pick, there is a Medicare Advantage plan for you. It’s always important to know the good and the bad things before you choose a health care program.
Before you cancel your Medicare Part A or Part B plan, spend time getting to know if Medicare Advantage plans are right for you. Medicare Advantage plans do not cover Medicare Part D plans, so be sure to keep that program. Medicare Advantage should offer the same things as Part A and B, but always read all the information before making a big insurance change.