Then there is the Medicare Advantage (Part C) option: These plans are operated by private insurance companies approved by Medicare. You must have both Parts A and B to enroll. These plans cover all the benefits of Parts A and B, but may also include prescription drug coverage and benefits like Vision, Hearing, Dental, and Preventative services. Many plans have low or $0 monthly premiums plus copays or coinsurance only for the benefits you use. There are four main types of Medicare Advantage Plans.
1. HMO- Health Maintenance Organization Plans.
A Medicare Advantage HMO comes with a network of physicians, hospitals and other health care professionals. You must get all routine care from one of the plan providers. Your primary care physician oversees your care and may refer you to specialists.
2. POS- Point of Service Plans.
This is a type of HMO plan that provides care through a network of local doctors and hospitals, but lets you receive certain services outside the plan's network, generally at a higher cost.
3. PPO- Preferred Provider Organization Plans.
A Medicare Advantage Preferred Provider Organization (PPO) plan provides care through a network of physicians, hospitals and other health care professionals. You do not need a referral to see a specialist, and you can go out of network for any covered services, generally at a higher cost.
4. PFFS- Private Fee For Service Plans.
A Medicare Advantage Private Fee For Service plan is a non-network plan. You can receive care from any doctor or hospital that accepts the plan's payment terms and conditions.
In all types of Medicare plans, if you have an emergency or need urgent care, you can go to the nearest doctor or hospital.
Coverage varies by plan. Not all plans are available in every state or county.
If you join a Medicare Advantage Plan, you must continue to pay your monthly Part B premium. Costs vary by plan, but all Medicare Advantage Plans offer an ANNUAL OUT OF POCKET MAXIMUM so you can budget for health care expenses and limit your out of pocket costs each year.
Let us HELP YOU FIND a Plan that WORKS for you! Call today! (602) 882-2587.
For additional resources contact:
Medicare 1-800-633-4227 24 hours a day, 7 days a week
Social Security Administration 1-800-325-0778
Adminstration on Aging 1-800-677-1116