Medicare Advantage Plans (also called Medicare Part C) were created by combining Part A (Hospital Coverage), Part B (Physician Services) and Part D (Prescription Drug Coverage).Together, these plans offer comprehensive healthcare insurance with a strong emphasis on preventive healthcare services and copays with maximum out of pocket costs for Medicare approved services. A Medicare beneficiary cannot have a Medicare Advantage plan and a Medicare Supplement at the same time.
Advantage plans include HMO Plans, PPO Plans, PFFS Plans (Private Fee for Service) and SNP Plans (Special Needs Plans). The SNP plans were created for Medicare eligible consumers with certain chronic conditions and specific health needs (examples: diabetes, cardiovascular disorders, chronic lung disorders, end-stage liver disease and many, and other chronic issues).
Advantage plans are offered by private insurance companies and typically provide benefits at least as good as original Medicare.There are many differences between plans including hospital and physician networks, drug formularies, health and wellness programs, dental, vision and hearing benefits. Monthly premium and copays will vary as well. While Advantage plans typically offer coverage through a specific network, emergency care is also covered outside of the service area (within the US).
During the Annual Election Period (AEP), October 15, 2016 through December 7, 2016, consumers have the ability to review their plans and to switch companies if appropriate.It is essential to make certain the health care providers you wish to see continue to accept the Advantage Plan you have.
Plan benefits, copays, premiums and provider networks can change yearly! To make certain your needs are still being met and your providers are still in your network, schedule 15 minutes on my calendar.