Understanding Medicare Advantage Plans & Coverage Options

Understanding Medicare Advantage Plans & Coverage Options

Medicare Advantage plans were created in 2003 to help bridge coverage gaps, such as preventative care, dental, hearing and vision services. These plans enable those who qualify for Medicare to purchase plans from private health companies like United HealthCare, Humana, Anthem Blue Cross, and others.

Because understanding the fine print can be a little complicated, the Clermont health insurance agents from Good and Associates Insurance Services have collected some important information for you below.

Benefits of Medicare Advantage

 Medicare Advantage plans are created to both provide additional coverage, as well as shoulder some of the financial burden. In addition to the 80 percent subsidy provided by Medicare, the Advantage Plan also covers an additional 17 percent subsidy. To make certain you won’t be overpaying on services its important to select a network that is both affordable, as well as one that isn’t too expensive when it comes to copayments and fees for hospital visits and other medical services.

How to Qualify for Medicare Advantage Plans

 Unfortunately, not everyone is eligible for Medicare Advantage plans. There are several stipulations to qualify for them, the first being that you need to have a Part A Original Medicare plan. You’ll also need to continue paying for Part B Original Medicare. Patients will also need to live in a plan service area and can’t be suffering from end-stage renal disease at the time you enroll.

There are Three Types of Plan Networks

 The first plan network for Medicare Advantage is the Health Maintenance Organization (HMO) network, which contains copays and limits users to only hospitals within the HMO network. The Preferred Provider Organization (PPO) enables users to visit any doctor that participates in that network and requires authorization to see specialists. The Private Fee for Service (PFFS) allows Medicare patients to visit any doctor, hospital or facility approved by Medicare.

Our Clermont health insurance agents can match you with the right plan!

 If you’re having trouble deciding upon the right Medicare Advantage Plan or service network, contact Good and Associates Insurance Services today. You can also visit us online to receive a free quote from one of our experienced health insurance agents in Clermont.

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