Medicare Advantage

Medicare Advantage plans are an alternative to Original Medicare (Part A and Part B) that allow you to purchase additional coverage such as prescription drugs, dental, vision, or hearing. You can sign up for one of these plans when you first enroll in Medicare, and you need to renew or switch plans every year. Serenity Almond, your local agent, can help you compare plans to find the right coverage at the right price.

Why Choose Medicare Advantage?

These plans, also seen as MA plans or MAPD plans (if they include prescription drug coverage), are offered by Medicare-approved private insurance companies. Medicare compensates these companies for handling your Part A and Part B coverage. In exchange, Medicare Advantage plans, also called Part C, can offer you additional coverage packages that you can’t find with Original Medicare.

One of the biggest gaps in Original Medicare is the lack of coverage for dental, hearing, and vision care. Medicare does not cover routine exams or equipment for any of these critical areas, which are especially important for aging seniors to maintain their health and quality of life. You can find a Medicare Advantage plan that offers packages for these areas and more. Some even cover health club memberships and fitness programs.

Another advantage of Medicare Advantage plans is the combination of prescription drug coverage and Original Medicare with Medicare Advantage Prescription Drug plans. These all-in-one plans mean you can choose a plan that covers your medications and in turn receive all of your coverage from one provider instead of choosing a separate Part D prescription drug plan.

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Coverage and Plan Types

With a Medicare Advantage plan, you receive exactly the same Part A and Part B coverage as under Medicare. Many offer additional packages for extra coverage.

Often Medicare Advantage plans have networks of providers. Make sure your providers fall within your plan’s network for the best rates. You may have to have a primary care physician (PCP) or need referrals to see a specialist, depending on your plan.

There are a few main plan types: HMOs, PPOs, MSAs, PFFSs, and SNPs. Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are easily comparable. HMOs have lower premiums but more restrictions. PPOs have more flexibility to choose the providers you want, at a slightly higher cost.

Medicare Savings Account plans have a savings account with funds that can be used for medical expenses. The funds may or may not roll over to the next year. Private Fee-for-Service plans allow you to see any provider that agrees to your plan’s payment terms and agrees to treat you.

Special Needs Plans (SNPs) are built for specific groups of people. Dual Eligible SNPs cater to people who qualify for both Medicare and Medicaid. Chronic Condition SNPs are made to care for people with certain medical conditions or comorbid conditions. Institutionalized SNPs are made for people who live and receive care from skilled nursing facilities, nursing homes, or other such institutions.

Enrolling in Medicare Advantage

During the Annual Enrollment Period from October 15 to December 7, you have the opportunity to drop a Medicare Advantage plan and switch to another or return to Original Medicare. You cannot be enrolled in both a Medicare Supplement and Medicare Advantage plan.

For all of your questions about Medicare Advantage plans and finding the right coverage in Northern Illinois, call Almond Insurance.