Article

The different types of Medicare advantage plans

Topic: Medical Advice and ResourcesPublished August 5, 2019

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If you are enrolled on Medicare Part A and Part B, you might have an option to enroll in a Medicare advantage plan. This plan which is commonly referred to as Medicare part C is an alternate way to receive the Part A and Part B services and it does not necessarily replace the ones you are using currently. There are severalkinds of this plans and there will be some changes in Medicare advantage plans for 2020 but that’s a topic for another day. The plans are available from Medicare approved insurance companies, private and those who enroll enjoy some extra benefits compared to what Part A and Part B has to offer. One of the benefits that they enjoy for example is getting prescription drug coverage or things like vison and dental coverage which are not covered by part A and Part B. Types of Medicare plan that are available where you live There are several types of Medicare plans and the following are the major ones that might be available where you live. Medicare advantage health maintenance organization (HMO) HMO has a network of hospitals, contracted doctors as well as other health care professionals who agree to work together and provide discounted services to the plan members. To get covered you will need to be a member of the network because in most cases they don’t cover for people out of the network unless it is an emergency, or the Medicare advantage plan approves the service in advance. HMO allows you to have a primary care physician (PCP) who will be coordinating your care and when the need be, refer you to an expert. When it comes to payments, the HMO plans are typically more affordable. Medicare advantage HMO point of service (HMOPOS) There is a variation of this plan that actually add more flexibility on how you get coverage and access the care, the HMO point of service (HMOPOS). It is more expensive but you are allowed to go out of the plan without a referrals. Medicare advantage preferred provider organization (PPO) Just like the HMO and HHMOPOS this Medicare plan is a contracted by network of health professionals. But different from the HMO the PPO does not allow to select your PCP. Another difference is that you can actually get benefits even if you are not inside the network but in most cases you will have to pay some extra costs. The PPO are more flexible compared to the HMO but as result they are a little more expensive. Medical advantage special needs plan (SNPs) The SNPs are practically just like the PPO, HMO and HMOPOS but the difference is that the plans are designed for people with special needs as the title is suggesting. They are usually tailored for people who live in a long term care facilities, who are eligible for Medicaid and Medicare benefits and finally people who have severe chronic conditions like heart failure. The medical plan always includes the prescription drug coverage. In order to get the medical plan, you must meet the conditions the plan is designed to help. Medicare savings account (MSA) The MSA woks with the same basics as the Health Savings Account so you might be familiar. It usually have two parts, the special savings account and high deductible insurance plan. The Medicare advantage plan will deposit money in your MSA account and the money can be used to cater for your Medicare covered services. The plan does not include the prescription drug coverage so if you are using the plan you might want to enroll for the Medicare Part D prescription drug plan. It is wise to review what the plan covers before you choose one and if you have any question you can always contact an eHealth licensed agent for some clarifications. Conclusion It is vital that you have a Medicare plan and with the Medicare advantage plans for 2020 the plans might be even cheaper. Choose one that is perfect for you.

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