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A Basic Guide on Medicare Advantage Plans

Author: Benedict Kemper
by Benedict Kemper
Posted: Jan 11, 2019

Medicare Advantage plan is a type of private health insurance offered by private insurance companies approved by Medicare. It provides coverage of Original Medicare (Part A and Part B) plus additional benefits and services including Part D coverage, co-pays, deductibles, out-of-pocket maximum, dental, vision, long-term and hearing care. That’s why the majority of Medicare beneficiaries enroll in Medicare Advantage plans in Texas.

Medicare Advantage plans also known as Part C plans. When you choose to avail Medicare benefits through Medicare Advantage plans in Texas, your insurer pays for your Medicare benefits and Medicare pay your insurer for your Medicare benefits. However, when you choose original Medicare, the federal government pays directly for your Medicare benefits when you avail them.

Medicare Advantage plans are of different types. Each Medicare Advantage plan has different medical benefits, costs, coverage, and services. But a Medicare Advantage plan must have Part A and Part B coverage. So no matter which Medicare Advantage plan you choose, you will have Original Medicare coverage.

Different types of Medical Advantage plans are Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-For-Service (PFFS) plans, Special Needs Plans (SNPs), HMO Point-of-Service (HMOPOS), and Medical Savings Account (MSA) plans. However, not every plan will be available in the area you live in. Therefore, before choosing one, first look for plans available in your area.

What are the advantages of Medicare Advantage plans?

Medicare Advantage plans offer numerous advantages. Let’s have a look at key advantages of Medicare Advantage plans.

Include Part D coverage

Original Medicare does not include part D coverage. If you want Part D coverage with Original Medicare, you have to enroll in a stand-alone Part D plan. And for that, you have to pay the monthly premium. Most Medicare Advantage plans include Part D coverage often for no additional premium. So when you want Medicare Prescription Drug coverage, choosing Medicare Advantage plans in Texas over Original Medicare is a better option.

A limit on out-of-pocket costs

This is the major advantage of enrolling in Medicare Advantage plan. Medicare Advantage plan has out-of-pocket (OOP) maximum whereas Original Medicare does not have an out-of-pocket maximum. So, if someone has $5000 out-of-pocket maximum with Medicare Advantage plan, he or she would pay up to $5000 for a bill of $50,000, and rest of the cost will be paid by the insurer. On the other hand with original Medicare, he or she has to pay the share of cost all the way to $50,000 which is not beneficial.

Additional medical coverage

Medicare Advantage plan provides extra benefits. Most of the Medicare Advantage plans in Texas include routine vision, hearing, long-term and dental care. Some plan will also include a monthly allowance for over the counter medicines, fitness memberships, and transportation benefits.

So this was the basic introduction of Medicare Advantage plans.

The Harrin Group, LLC is an independent insurance agency providing health insurance, life insurance, Medicare Advantage plans, Medicare Supplement plans, retirement solutions, and annuities for San Antonio and all of Texas, California, and Florida. To know more, visit https://www.harringroup.com/.

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I'm a freelance copywriter and I write on a variety of topics.

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Author: Benedict Kemper

Benedict Kemper

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Member since: Sep 26, 2016
Total live articles: 36

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