Things to Know About Medicare Advantage Plans

There are more than 60 million people who get their health care coverage through Medicare. About one-third of those choose to receive benefits from Medicare Advantage instead of the original Medicare plan. Many private insurers offer advantage plans and will constrain you in providing a specific network only of care providers. Although, Medicare Advantage plans are more cost-effective when compared to the Original Medicare.

Medicare commenced in the year 1965. Many people call themselves the experts understanding the plans Medicare offers, but there are a variety of rules and options for the diverse Medicare plans. They all can be confusing. Refer to a Medicare Insurance Agency that will help you to choose the best plan and evaluate the benefits associated with each particular plan. There are 5 important things that you must know about health care plans:

  1. You have to choose a Medicare Advantage plan from different options

As there are many Medicare Advantage option plans available, you do not have to choose a traditional Medicare plan. You can choose from:

  • Medicare Parts A and B: This plan aims to provide hospital care and access to any of the doctors or hospitals across the country that accepts the Medicare plan. This is also known as the “original” Medicare.
  • Medicare Advantage plan or Medicare Part C: This is a plan that an individual can buy from a private insurer providing the benefits of Medicare.

Along with these options, you will need to also select a Medicare Part D plan that will provide you with coverage for prescriptions, including drug prescriptions. There is a supplemental policy that is referred to as a Medicare plan that many people also prefer to add as well. 

This will provide you with additional benefits, including deductibles. Some of the plans in Medicare also have a limitation on other expenses meaning that a person has a yearly limit of what he or she has to pay.

When individuals choose a specific health care plan, it will include the prescription drug coverage as well. This ensures that you do not have to choose a separate plan for medications, such as through the Part D plan. Sometimes, the  health care plans will also include eyeglasses and dental coverage as well. However, it varies for every individual’s plan.

  1. Timeframe in which you need to sign up for Medicare Advantage Plans

There is a time period of 7 months total that is given to a person to sign up for the health care plans. The time begins 3 months that person turns 65, the month the person is born in and the three months following the person’s birth month.

Some people may automatically become enrolled in Medicare Parts A and B whereas others may have to sign themselves up. If you are not sure which category you fall in, automatic enrollment or not, please reach out and check with the Social Security office.

If a person is not enrolled automatically and fails to enroll within the time frame, they must enroll then they will have to eventually pay a penalty. The penalty will increase every month that it is unpaid. Therefore, you must be aware of when to enroll in your specific health care plan.

  1. A person will not always qualify for Medigap plan

If you intend to enroll in the Original Medicare plan, then having a Medigap policy will be added as supplemental insurance. The Medigap will be paying some of the costs that are not covered in the Medicare plan, including deductibles and copayments. While your Medigap is open for enrollment then you are free to purchase any policy for Medigap according to your health status. Although, after that time lapses then you will not be able to get the most beneficial Medigap policy.

  1. There may be limitations on dental and vision coverage.

Medicare plans may not cover dental care until an individual gets the dental services or applies for an emergency dental process while in the hospital. The eye coverage, including the provision of eyeglasses is also limited in the original Medicare plan. The plan may cover eye exams for some health condition, including macular degeneration and glaucoma. The hearing aids are also not covered and may require you to purchase the health care plan or supplemental insurance to accommodate those costs.

  1. Medicare Advantage plan has various parts

You might confuse the health care plans with other health insurance plans and think that it is one-stop shopping. However, if you are signing up for a Medicare Advantage plan or traditional Medicare plan, then you need to also enroll for Medicare Parts B and D.

These parts cover just the medical care of the patient and prescription drugs coverage. If you want additional coverage, then you might require a supplemental plan to help you in paying any extra expenses.

If you still have any questions regarding Medicare plan then you must know that there is a State Health Insurance Assistance Program (SHIAP) for every state. The SHIAP has various counselors who are available to answer all of your questions regarding Medicare or the health care plans.

You can also seek help from Chermol Medicare & Insurance Solutions (CMIS) who will provide you with necessary information about the Medicare plans and help you decide which plan will be the best for you.

The experts of CMIS will be there to assist you in choosing plans according to your health status that will include health insurance, medical insurance, dental, vision, and hearing along with emergency assistance. This can simplify your choice in selecting the Medicare plan that is best for you.

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