What Does Medicare Advantage Cover?
Medicare Advantage Plans in Pennsylvania
Medicare Advantage Plans are a type of Medicare plan that is offered by a private company. This private company contracts with Medicare, and they provide Part A and Part B benefits. When you enroll in a Medicare Advantage plan, most Medicare services are still covered by the plan.
Joining a Medicare Advantage Plan can be very worthwhile, and save you some money. These plans have networks, premiums, and cost-sharing measures that are different than Original Medicare.
Choose the Right Plan
Working with Michael Braun at Franklin Benefits Group LLC to analyze your Medicare Advantage options is the best way to make sure you are choosing the right plan for you, and your needs.
When you speak with myself or a member of my team, you can rest assured that my team and I are very knowledgeable when it comes to how these plans function.
Common Types of MA Plans
- Health Maintenance Organization (HMO) Plans
- Private Fee-for-Service (PFFS) Plans
- Preferred Provider Organization (PPO) Plans
- Special Needs Plans (SNPs)New Paragraph
Important Points
- Medicare Advantage Plans can not charge more than Medicare Part A and B (Original Medicare) for certain services.
- Medicare Advantage Plans have a yearly limit on out-of-pocket costs. After you pay this amount, you don't have to pay anything for additional, covered services.
- Providers can join or leave a network at anytime - if this happens, you may need to choose a new provider.
What You Need to Know
The main thing to know is that for most people, out-of-pocket costs will likely be lower with a Medicare Advantage Plan.
With an Advantage plan, you still get Part A and Part B coverage, and some Advantage plans offer additional benefits that Part A and B don’t cover. Things like dental, hearing and vision.
When choosing a plan, you can see if the service or services you are interested in are covered BEFORE enrolling in the plan. If you need help doing this, our Medicare Advantage agents are always happy to provide our input after you tell us what you are looking for.
Folks with pre-existing conditions don’t have to worry. You can still join a Medicare Advantage plan if you have a pre-existing condition. An exception to this rule is if you have End-State Renal Disease.
Medicare Advantage vs. Original Medicare
Wondering about the differences between Original Medicare (Part A and Part B) and Medicare Advantage (Part C)?
The main difference is in how you get your coverage. For Original Medicare, you can visit any doctor/hospital that takes part in Medicare. Most hospitals and doctors participate.
On the other hand, Medicare Advantage plans require you to use the plan’s provider network. Most people can expect to pay co-pays when they visit either their primary care doctor or their specialist.
It is important to factor these, and other considerations in to any decision you make regarding your Medicare choices. We know that it is overwhelming at times, and it can seem easy to make the wrong decision if you are not informed.