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Types of Medicare Advantage
Posted: Jun 04, 2019
Medicare advantage as an insurance plan in Medicare is broken down further into different types which are five in number, it is important that you get to know these breakdown before you think of enrolling, these types include;
1. Health maintenance organization (HMO)
This is the plan that has the lowest premium, and as a result majority of people choose this plan for affordability purposes. With this plan you can get the very basic services from the provider who has been given the contract to provide the services, for the normal services,. But if you get an emergency you can just go to any hospital that you can access fast services, however, this situation is only for emergencies, if you go outside the network when it is not an emergency you can face the consequences, unless you have been referred to a specialist outside the network.
2. Preferred provider organizations.
In this plan the option that is available allows you to visit a specialist or a provider in the same network who provides the service at a subsidized but you can as well use someone who is not in the network. This plan is a little bit expensive compared to a HMO because of its flexibility nothing more, because they very same benefits. In this plan you get to choose the specific specialist, this can be very convenient since you don’t need to stay there waiting for referrals before you see a specialist since you already chose one. Some PPOs have a benefit of drug prescription, if you enroll in one of these you will need not to enroll with part D which offers the same service.
3. Private fee-for-service (PFFS)
This is the most flexible of them, since they are offered by Medicare, in this plan you are free to go and see any doctor or specialist, as long as they are registered with Medicare, you are not tied to anything in this plan. Some of these PFFSs have a network which means you can go to any doctors if you are in one and get treatment even if they don’t know you physically. In this plan, there is nothing like a primary care physician that you have to pick or get referrals and so it’s free to see any doctor, but take caution because if you go to see a doctor who is not compliant with Medicare, they can reject the insurance forcing you to pay from your pocket.
4. Medical Savings Account (MSA)
The plan is not very much used by people. For this plan, the company deposits money in your account for you to payout your medical bills. You don’t need to have been covered by Medicare to pick this plan. You can choose to use the money deposited in the bank for other purposes other than medical expenses but then you will get taxed, unlike if you used the money for medical expenses where it is not taxed. In this plan there is no inclusion of drug prescription part, this implies that, for you to enjoy this benefit, you will have to enroll to Part D which specializes in this type of benefits.
When choosing between the plans in Medicare advantage, you should do a thorough assessment to determine whether it is suitable for you or not. Try to find a plan that will minimize your expenses when you have to deal with medical bills. Affordability is the key thing to consider before you choose any of the plans available in Medicare Advantage, two you will need to check on flexibility of the plan, if the plan allows you to find a private doctor or you just get tied to the doctors in the network. There are also Medicare supplement plans for 2020 that will be coming with a few changes which might alter some things, but this might just be specifically for medigap. Finally you will need to check on the availability, some plans may not be available in some areas for some reasons, maybe they are not so popular in the region or maybe any other reasons.
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