Additional coverage for more healthcare services
If you need more coverage beyond Plans A and B, Plan C may be a good fit for you.
As an eligible individual, you can choose to get your Medicare Part A and Part B benefits through a Medicare Advantage plan, which is also known as Medicare Part C. Many plans offer the following benefits:
- Medicare Part D prescription drug coverage
- Hearing exams or hearing aids
- Routine dental care
- Eye exams, eyeglasses, or contact lenses
- Wellness benefits such as gym memberships
Many options under Plan C include prescription drug coverage. However, you also have the choice to add a stand-alone Part D plan with specific Medicare Advantage plan types.
Enrollment in Medicare Advantage
Eligible individuals should enroll or switch to a different Medicare Advantage plan during two periods:
- Initial Enrollment Period
- Annual Open Enrollment Period.
In special cases, you can enroll or switch to a different plan during a Special Enrollment Period. Furthermore, you can’t be denied coverage or charged more based on your health status.
The Costs Associated with Medicare Advantage
When enrolled in Medicare Plan C, you can choose providers in or out of the network. The costs for providers and varying services can differ depending on whether the provider is in-network vs out-of-network. In most cases, you can expect to pay less for care received from in-network providers when compared to providers outside the network. Additionally, you may or may not need referrals to see specialty providers, depending on the plan you choose.
All plans are required to offer nationwide coverage for emergency care, urgent care, and renal dialysis. Some plans can also provide emergency care overseas.
The cost of Medicare Advantage plans varies by plan provider. Some plans may charge premiums, deductibles, copays, or coinsurance depending on the plan and services; and plan premiums can change each year. Medicare Advantage plans are required to set
an out-of-pocket maximum to help provide some financial protection for out-of-pocket costs. It should be noted that Original Medicare doesn’t offer an out-of-pocket maximum. Within a given calendar year, if you reach the out-of-pocket maximum, then your Medicare Advantage plan will then pay for all your covered costs for the remainder of the plan period.
Get the Right Medicare Advantage Plan for Yourself
Landel Insurance can help individuals select the right Medicare plans for their needs based on their health status, location, and budget. With a myriad of plans to select from the decision can seem daunting. Let us take the guesswork out of choosing the right type of plan and get you covered today!
Which Medicare Advantage Plan is Right for You?
HMO Plans
HMO stands for Health Maintenance Organization.
In these plans, a patient’s medical coverage is restricted to a designated network, consisting of a group of physicians.
PPO Plans
PPO stands for Preferred Provider Organization, where an insuree is free to choose any doctor or physician they might want to consult for their health condition. This can include doctors within and beyond the scope of their network.
PFFS Plans
PFFS stands for Private Fee-for-Service plans. As the name suggests, this insurance plan consists of a process in which the federal government pays private companies to offer Medicare benefits for individuals.
SNP Plans
SNP plans for Special Needs Plans. According to this Medicare plan, people with specific diseases or health conditions are qualified to get SNP Medicare benefits. People in these groups can choose to customize their plan and its benefits according to their doctor’s recommendation and health condition.
Get Your Free Insurance Quote Today.
Medicare Advantage vs Medicare Supplement
If Medicare Advantage does not meet your needs for a healthcare plan, perhaps Medicare Supplement Insurance is a better option. Landel Insurance can help you navigate various plan types whether you are in the Open Enrollment Period or looking to add coverage at a later date.
Individuals can choose to add Medicare Supplement Insurance to their Orginial Medicare plan if they are in need of more flexibility and assistance with covering costs beyond what Plans A and B can cover.
Deductibles, copayments, and coinsurance for in-network care and services count towards out-of-pocket costs. Is it also important to now that the following costs do not count towards the out-of-pocket maximum:
- Premium payments
- Drug costs
- Costs of extra health services a plan may offer such as vision or dental
Coverage and costs will vary from plan to plan, by location, and by plan provider. Some plans do not cover the cost for care outside the plan’s network, except for emergency care, urgent care, and renal dialysis. For some plans, out-of-network care may also result in higher copays or coinsurance. If you need help choosing the best plan for you and your needs, consider working with Landel Insurance to narrow down the options.
Medicare, or Original Medicare is Plan A and Plan B. These plans offer coverage for hospital stays and inpatient care and doctor visits and outpatient care, respectively. Medicare Advantage combines the benefits of Plan A and Plan B with additional benefits including prescription coverage, routine vision and dental care, hearing exams and hearing aids, as well as other wellness benefits.
Have Additional Questions?
Landel Insurance can provide you with additional insights regarding your insurance questions. Please don't hesitate to contact us!
Partnered With
Explore your Medicare Plans with WellCare.