What Is Medicare Advantage?

What Is Medicare Advantage?

Medicare Advantage is a health insurance plan that is designed for people who are age 65 and older to cover their doctor and hospital expenses. The program is sanctioned through Medicare, but it is sold through insurance companies.

Medicare Advantage plans are a replacement for the benefits that come from Original Medicare, and the Medicare Advantage benefits overlay the benefits from Original Medicare. All Medicare Advantage plans must be approved and sanctioned by Medicare.

Medicare Advantage Plans Have Many Options

Medicare Advantage Plans can be PPO plans, HMO plans, Private Fee For Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans (MSA).

Medicare Advantage Plans are very similar in benefits to a group health insurance plan that a person would have available at a workplace environment.

Medicare Advantage Plans differ from area to area in the US and most generally from county to county. The premiums are subsidized by Medicare so they are very low in most cases, and in some instances there is no charge to the participant at all, which makes them very popular.

Enrollment can be made each year during the Open Enrollment Period, which runs from October 15 to December 7 for 2015. There are no restrictions for coverage and there are no pre-existing conditions that are excluded. The only requirement is that the individual enrolling must be enrolled in original Medicare parts A and B.

The other question to “What is Medicare Advantage?” is the scope of coverage that is available. The scope of coverage is quite broad with prescription drugs being added to the coverage. The plan covers both hospital and doctor, plus ambulance and emergency coverage. For the most basic coverage there may be deductibles and co-pays, but they are relatively small amounts.

For hospitalization, there may be an up-front copay of between $300 and $1,000, but everything is covered after that. Dental, chiropractic and mental health benefits are also available as well as wellness programs designed to enhance a person’s overall well-being.

Advantages of Medicare Advantage Plans

The main advantage of Medicare Advantage plans is that the cost is very inexpensive to free to the individual for the medical insurance coverage that is offered, no matter what the state of a persons health may be. The coverage is very comprehensive, so that a broad range of medical help is available. Checkups, tests, specialists, and hospitalization are all covered in a very thorough manner. Dental, mental health and chiropractic are also available on some plans and this will vary from company to company.

Disadvantages

Plans are available depending upon a person’s location. One plan may be available in one county, but unavailable in a county right next door. Most of the Medicare advantage operate through networks of doctors and hospitals. A person’s favorite doctor or hospital may or may not be in the network.

As far as the drug coverage, the drugs are in a formulary which determines what drugs are available and how they are available. Some drugs require that certain steps be taken before a drug will be available, and that may or may not be what a doctor recommends.

All in all, Medicare Advantage plans serve a very needed purpose in providing low-cost to free, very comprehensive medical coverage for people who are on Medicare.

Medicate Advantage And Dental Care

Many Medicare Advantage plans don’t cover dental expenses. And those that do often have a very limited coverage amount. If you’re facing some big dental expenses soon, you might want to check out the AmeriPlan Dental Plus Discount Dental Plan. While not insurance, AmeriPlan has secured big discounts with over 78,000 dentists in the US with no waiting period or plan limits.

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