If you're turning 65, chances are you'll consider enrolling in Medicare. There are a number of plans available including a Medicare Advantage Plan. This type of health plan is offered by a private company that contracts with Medicare and is also known as Medicare Part C or MA Plans.
Beneficiaries with Medicare Advantage have Part A and Part B benefits. Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans.
Things to know about Medicare Advantage Plans
There are some things to know about Medicare Advantage Plans if you're considering enrolling.
- Those with an Advantage Plan are in the Medicare program and have the rights and protections issued under Medicare.
- Your Medicare Advantage Plan offers complete Part A and Part B coverage.
- If you choose to join a clinical research study, some of the costs associated with it may be covered.
- Even if you have a pre-existing condition, you are still eligible to join a Medicare Advantage Plan, except for those who have end-stage renal disease.
- There is a yearly limit on out-of-pocket costs for medical services with Medicare Advantage Plans. The limit can vary from year to year but once you reach it, you'll pay nothing for covered services.
- Providers can choose to join or leave a plan's provider network at anytime. A policy may also decide to stop participating in Medicare which means you'll have to join another health plan or return to Original Medicare.
- You can only join a Medicare Advantage Plan at certain times during the open enrollment period from October through December.
- Should you choose to go to a health care provider or facility that is outside your plan's network, your services may be covered but a higher cost to you.
- Under a Medicare Advantage Plan, you won't be charged more for chemotherapy, dialysis and skilled nursing facility care than if you were enrolled in Original Medicare.
- Most Medicare Advantage Plans provide prescription drug coverage.
Questions to ask
Before choosing the policy that suits your health heeds, consider asking a few questions to compare plans.
- You'll want to know if the plan offers benefits Original Medicare doesn't, such as vision, hearing, dental or prescription drug coverage. If you want the extra benefits, your premium may be higher and if you need medication, enrolling in Medicare Part D is always an option.
- Ask what your share of the costs for services and supplies will be.
- Be sure to find out if a plan has a network of providers for some or all of the services you may require.