What is a Medicare Advantage Plan?

A Medicare Advantage plan is a plan offered by a private insurance company that combines Part A (hospital insurance) and Part B (medical insurance) in one plan.  Most plans also include prescription drug coverage (Part D).  Another term for a Medicare Advantage plan is Part C.  Medicare Advantage plans will often include additional benefits not provided by original Medicare such as a gym membership, preventive dental coverage, vision coverage, credits for over the counter items, etc.  We have many plans in our area with a 0 premium.  All of these factors make Medicare Advantage a very attractive offer for Medicare eligible individuals and help to fuel the continued growth of these plans.  There are many options to choose from when deciding on a Medicare Advantage plan, that is why we recommend you speak to a licensed representative who can help guide you through the process.

Am I eligible for a Medicare Advantage plan?

You are eligible for a Medicare Advantage plan as long as you have original Medicare parts A and B, live in the plan’s service area, and don’t have ESRD (end stage renal disease).  Medicare Advantage plans can vary quite a bit from area to area so it is important that you consult with a qualified professional that knows the ins and outs of the plans offered in your neck of the woods.

Different types of Medicare Advantage plans

Medicare Advantage plans are network based plans.  Meaning that there is a contracted network of physicians, specialists, facilities, and hospitals that can vary from plan to plan.  It is important that you check to be sure that any medical professionals you need are in the plan’s network.  The two main types of plans that we see in our area are HMO plans and PPO plans.  You have probably had one or both of these types of plans through employer group insurance at one point or another in your working life.  With an HMO plan you must generally work within the plan’s network, you typically aren’t allowed to go out of network on these plans (some exceptions can apply).  On a PPO plan your co-pays and out of pocket costs will be lower if you remain in network but the plan also allows you to go to an out-of-network medical provider for a higher fee.  It is important to note that in the event of an emergency you can seek care anywhere you want, you won’t need to worry about staying in-network in that event, all hospitals are treated as in-network in the case of an emergency.  This emergency clause is true whether the plan is a PPO or an HMO plan.

Summary

With all of the different options out there, a common question that we get from clients is “What is the best plan? This is a subjective question and really should be phrased “what is the best plan for me?” Everyone’s needs are different, that is why at R & K White Financial Corp we take the time to do a through needs analysis so that we can make appropriate recommendations.  Medicare Advantage plan enrollment is growing at a rapid pace.  These plans can be a very good deal for the consumer.

Enrollment Questions?

The R&K White Financial Team is here to answer any questions or concerns regarding Medicare and enrollment. Please don’t hesitate to contact the R&K White Financial Team with any Medicare questions. : (407) 509-7756  : rwhitefinancial@outlook.com

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