Philadelphia Medicare Part C Plans

Medicare Part C, or Medicare Advantage, is a type of bundled health care plan that comprises hospital, medical, and some medication coverage for members who enroll. Philadelphia Medicare Part C plans can also incorporate additional services such as dental, vision, and hearing care, which are not included in the traditional Medicare plans. Coverage for each individual Part C plan may differ. 

Medicare Advantage offers care recipients more coverage as compared to traditional Medicare plans (Parts A and B). Members enrolled in Philadelphia Medicare Part C plans are free to choose from different doctors and medical staff included in the network. 

Medicare Part C plans in Philadelphia are mostly offered by Medicare-approved private health insurance organizations. In order to participate, the companies must abide by the rules and regulations set by Medicare. Those enrolled in Medicare Advantage must pay a certain amount each month for their policy.

Some people confuse Medicare Part C and Part D, but they cover different medical expenses. Whereas Part C covers additional medical expenses not covered in Parts A and B, including certain drugs, Medicare Part D plans in Philadelphia cover prescription drugs only. 

Regarding Medicare Advantage or Part C, there are several types of plans to choose from:

Health Maintenance Organization (HMO)

If you want to receive discounted treatment in your HMO plan, then you must get care from a particular network that provides health care treatment. People who have this plan can take advantage of the discounted services by doctors, hospitals, clinics, and health care providers. Under an HMO plan, a member will get primary care from a doctor to receive special medical care. A member will have to pay for the services if he or she is getting care from an out-of-network provider.

Preferred Provider Organization (PPO)

Preferred plans are generally similar to Health Maintenance (HMO) plans in that an individual can save money if they choose an in-network provider. However, in some PPO plans, a company might also provide some health care from an out-of-network provider. In PPO plans, what is covered may not include the referral of primary care providers. 

Private Fee-For-Service (PFFS)

Members who choose PFFS plans have set agreements with the specific health care providers who provide Medicare-approved services. As per this agreement, doctors may charge some money for the services offered. Some of the PFFS plans may require an individual to see in-network doctors, while other plans may not.

Special Needs Plan (SNPs)

These health care plans are especially for those who have certain chronic medical conditions. Some of these conditions may include chronic heart failure, diabetes, dementia, kidney disease, HIV, and end-stage liver disease. Individuals with these conditions generally have more frequent doctor visits and use more types of medication. Generally, most of the special needs plans incorporate prescription drug coverage.

Medical Savings Account (MSA)

These types of Medicare plans blend high-deductible insurance plans with a medical savings account. A deductible refers to the amount a person has to spend on medical costs before the insurance company begins to pay. Individuals with MSA plans often have high deductibles. They can make use of their money from their Medical Savings Account to fund health care expenses until they meet their deductibles. 

With the variety and complexity of different Medicare plans, it makes sense to calculate the potential costs of each one in order to save money. However, this can ultimately turn out to be very time-consuming work. Most will want to consider several factors while choosing a plan, not limited to but including their income, health conditions, and medications. 

Medicare plans have monthly premiums that commonly range from zero dollars to $25. According to the Kaiser Family Foundation (KFF), the average premium for a Medicare plan is about $25. However, some plans can be very expensive, with premiums exceeding $200. 

Every plan has its own deductible, premium, and level of coverage. Thus, annual costs can differ by thousands of dollars. While knowing the basics of Medicare can be helpful, but to get the best plan and rates, nothing can beat a consultation with the experts. If you are trying to choose a Medicare plan but need help, contact Chermol Medicare and Insurance Solutions today.