While Original Medicare (Parts A and B), with a Medicare Supplement and prescription Drug Plan (Part D) are a wonderful combination for comprehensive health care, there is another option to health coverage through the Medicare system.
Part C of Medicare, or Medicare Advantage
It is NOT Original Medicare, and you are no longer on Original Medicare when you choose this option.
Medicare Advantage started in 2003, and was introduced nationwide in 2006. It was designed as an alternative Medical Plan for folks on Medicare. Medicare Advantage (Part C) is a combination of Parts A and B, and most of the time Part D. It may be very similar to the health insurance plan you currently have that is not Medicare. There are some major differences in Original Medicare and Medicare Advantage:
• While the Federal Government is your Insurer with Original Medicare, Private Insurance Companies are your Insurer with Medicare Advantage. You will no longer use your Original Medicare Card (the red, white, and blue card)
• There are copays, deductibles, and coinsurances to pay each time you use Medicare Advantage, unlike Original Medicare with a supplement
• Medicare Advantage will offer a Prescription Drug Coverage within the plan, so there is no need to purchase a separate Part D plan
• Most Medicare Advantage plans are either HMOs or PPOs. Meaning your Doctors, Hospitals, Pharmacies, etc… must be a part of the Insurance company network.
• Medicare Advantage are based on Managed Care and Preventative Care. You usually have a Primary Care Physician who will be in control of your health care
• There are never any Health Questions asked. They are Guarantee Issue all of the time. You cannot be turned down coverage
• Typically, in most cases, the Fixed Monthly Premium Cost is less expensive than that of Original Medicare with a Supplement and Drug Plan. Although – YOU STILL PAY THE PART B PREMIUM FOR MEDICARE!!
• Unlike Original Medicare, Medicare Advantage may offer Some Dental, Vision, or Hearing coverage
• Medicare Advantage Plans are designed and centered around Populated areas, and are offered by county. The plans differ in most cases from county to county. The more rural you are, the less plans are available – this is what makes Medicare Supplement Policies very popular in Rural Counties
• Each companies’ plans are different. They do not have to offer the same thing like Medicare Supplement Coverage. They are different from one company to another
• Once you enroll in a Medicare Advantage Plan, you are IN the plan. There is an Annual Enrollment Period (AEP) each year in the fall to where you can choose a different plan, company, or leave Medicare Advantage and return to Original Medicare. In any case, your coverage is a calendar year contract from Jan 1 to Dec 31. You cannot change plans any time you want to unless you qualify for a Special Election Period.
Contact Brian to find out if you are in a Special Election Period!
Medicare Advantage Plans are a very good option for lots of folks. They do have their application and have been very good health coverage for millions of people on Medicare, but Medicare Advantage is easier to understand when you take the time to spend with a knowledgeable person to explain it to you in person. Knowing the facts about Medicare Advantage (Part C) is the first step in making an educated decision on which route to take with your Medicare Choices. Brian’s expertise is knowing the facts and presenting them in a very understandable way. Brian has the ability to fit you to the right plan from the right company for your situation. Do Not try to do this on your own, and Do Not put off learning about these plans because you can do this VERY WRONG, or VERY RIGHT. The better educated you are, the better choice you will make for you and your family.