Ever since they were first introduced in the Balanced Budget Act of 1997, Medicare Advantage plans have been gaining in popularity.
Also known as Part C or MA Plans, Medicare Advantage is another way to get Part A (hospitalization) and Part B (medical services) coverage offered by Original Medicare, often with Part D (prescription drug) coverage included. These plans are offered by Medicare-approved private companies that must follow the rules set by Medicare. They set a limit on what you have to pay out-of-pocket each year for covered services, and some plans even offer non-emergency coverage out of network, typically at a higher cost.
The most common types of Medicare Advantage plans include:
- Health maintenance organization (HMO) plans
- Preferred provider organization (PPO) plans
- Private fee-for-service (PFFS) plans
- Special needs plans (SNPs)
Less common types of MA plans that may be available include HMO Point of Service (HMOPOS) plans and a Medicare Medical Savings Account (MSA) plan.
Why might you choose a Medicare Advantage plan if you are 65 or older? Let’s count the reasons:
- They offer low or $0 monthly premium payments. Depending on the plan, your costs will vary, and you will continue to pay the Part B premium to Medicare. That’s why it’s important to shop around before you choose a plan.
- They provide you with a financial safety net. MA plans set an annual out-of-pocket limit. If your health care costs reach the limit, your plan will cover 100 percent of your Medicare-coverage costs for the remainder of the year. In comparison, there is no out-of-pocket protection with Original Medicare.
- Unlike Original Medicare, MA plans provide dental, vision, fitness, and hearing coverage. These are part of the benefit packages of most Medicare Advantage plans.
- They provide additional benefits designed to support your health and well-being. Many MA plans provide total health and wellness packages, including in-home medical visits, transportation to medical appointments, coordinated care, and telemedicine (virtual telehealth doctor visits).
- MA plans offer built-in prescription drug coverage. There is no need for a separate Part D plan.
- They provide you with one complete health care coverage plan. There is no need for supplemental insurance when an MA plan covers everything from doctor visits and prescription drugs to hospital care and more. You pay one premium and have one point of contact for any Medicare questions you may have.
- They provide easy referrals to providers and specialists. With the oversight of your primary care provider (PCP) and a widespread network, your MA plan allows you to quickly find the care you require, and your PCP can easily refer you to the specialist you need.
- They provide access to emergency care nationwide. In the event that you need urgent or emergency medical care while away from home, your Medicare Advantage plan provides coverage throughout the United States.
- Most MA plans provide comprehensive care coordination. By bringing all your care under one umbrella, an MA plan avoids overlapping tests and procedures, promotes better communication, and thus helps improve health outcomes.
Aside from providing you with more than the basic benefits of Original Medicare, Medicare Advantage allows you to choose a plan that fits your personal needs.
Doctors Medicare Advantage Plan in Lakeland, Florida
At Palm Medical Centers, we work with most Medicare Advantage health plans to make excellent health care accessible to you and your loved ones.
For more information about MA plans or to schedule an appointment, please call Palm Medical Centers today at (833)500-PALM (7256) or send us a message now. With 26 clinics conveniently located throughout Central and South Florida, there’s bound to be a Palm Medical Centers location nearby to serve you.