Medicare Advantages Plans

What is Medicare Advantage Plans?

Also known as Medicare Part C, it is an alternative type of coverage to Medigap. 

Advantage plans were devised with a maximum out-of-pocket cap on your medical spending. Consider this as a safety net. In case you have massive health spending that results in an out-of-pocket limit, then Advantage plans save the day by paying for the remainder of the calendar year. Part D expenses are not included and are calculated separately. 

Another feature of Advantage plans that is quite popular is that they often come with a built-in Medicare Part D drug plan that saves you from separate purchasing.

Medicare Advantage Plan

A Medicare Advantage plan is a Medicare-approved private health insurance plan. Instead of going for the traditional Medicare, you may choose to avail your Part A, B, and D benefits from a Medicare Advantage plan. These Medicare private insurance plans usually include an HMO or PPO network of doctors.

Medicare Advantage Explained

Medicare Advantage plans Florida are devised as an alternative to Original Medicare and Medigap. When you join one of these plans, Medicare pays a fixed monthly amount to the Advantage plan for your care. In return, the plan will deliver all of your Part A & Part B services, and all of your medical risks are taken care of.  

While being enrolled in an Advantage plan, you must continue to pay your Medicare Part B premium. You must also be enrolled in Medicare Part A and B, both along with living in the plan’s service area. 

Do note that Medicare Advantage policies are not Medigap plans. They function differently because they pay instead of Medicare.

Medicare Advantage Coverage

Many of you who are new to Medicare will have questions regarding the positives and negatives of Florida Medicare Advantage plans vs Original Medicare, which is understandable. 

Original Medicare comes with deductibles and a 20% coinsurance on Part B. On the other hand, with the Advantage plan, you will use the plan’s network of providers, which is usually local. When you receive healthcare services, you will pay co-payments. Each plan sets its own cost-sharing. 

For example, for a primary care doctor visit, you might pay a small copay, and to see a specialist, you might pay a higher copay. Similarly, some plans will charge you on a daily basis, while other plans might charge a flat amount once for the entire stay. 

One of the most significant differences is perhaps in the changes to the plans. However, Medicare may include small changes to Part A and B deductible, but the 20% coverage on outpatient services remains unchanged. Part C Medicare Advantage plans observe change on an annual basis. 

Medicare states itself: ”Limitations, co-payments, and restrictions may apply, and each plan’s benefits, formulary, pharmacy network, provider network, premium, and copayments may be changed on January 1 of each year. Members need to be diligent about reviewing the plan materials sent to them each year in September to see what’s changing.”

People availing Medicare had only Medigap plans to choose from for many years. Although these plans have brilliant coverage, still, they are not affordable for everyone. These people only availed the original Medicare health plan. The problem occurred when illness struck, and they found themselves with bills for expensive deductibles and coinsurance that they could not afford.

At this point, they would try to get a Medigap plan, but as by now they have developed health issues, they do not qualify for it, often leading to medical bankruptcy. 

To remedy all this, Medicare Advantage plans Florida, have a solution. Medicare Part C provides lower-cost plans or budget plans with just one health question. People can now join these lower-cost plans during the enrollment periods. 

Let’s learn more about Medicare Advantage and what it is exactly.

Joining a Medicare Advantage Plan

Part C Advantage plans include different networks, premiums, and cost-sharing. It is advised to work with an insurance agency that is well-versed with such plans as this will allow you to consider all the variables involved and make the right decision for choosing your insurance company. Our firm specializes in how Medicare Advantage plans Florida work. 

Feel free to complete our questionnaire contact form so that one of our agents can reach out to you and get the ball rolling.