Understand What Medicare Advantage Plans Are & How to Compare Them
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Medicare is a federal healthcare program established by the government. It caters to permanent legal residents in the US who are 65 and over, as well as people with certain disabilities. It was designed to mitigate the increasing medical costs that you may face as you get older.
Once you reach 65 years old and if you’re receiving social security benefits, you will automatically be enrolled in Original Medicare. This is split into Medicare Part A and Part B. Medicare Part A is hospital insurance and covers a variety of inpatient treatments and facility care. Medicare Part B covers doctor visits and some other medical services and supplies.
So, how do you know what to look for when comparing plans? Let’s dive a little deeper….
Medicare Part A has a $1484 deductible and Part B has a $203 deductible. Both plans are also coinsured, meaning that you pay a portion of the costs. If you’ve paid Medicare taxes for 10 years, Medicare Part A will be free. Otherwise, you will pay monthly premiums up to $471 for Part A, and at least $148.50 for Part B.
While Medicare Part B does cover some medical supplies and certain prescription medications, Original Medicare doesn’t cover many prescription drugs or long-term care. These include hearing aids, eyeglasses, most dental care, and cosmetic surgery.
Medicare Part D can help to cover the cost of other prescription goods. But another health plan, known as Medicare Part C or Medicare Advantage, provides the benefits of Parts A, B, and sometimes D as well as other additional coverage, like vision, hearing, and dental care.
Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. These plans are known as an “all-in-one” alternative to Original Medicare. There is also a yearly limit on out-of-pocket costs.
However, you will need to use certain doctors in the plan’s network, so you may be limited to certain areas. This differs from Medicare, where you can go to any doctor or hospital in the US who accepts it. You may also need a referral to see a specialist, and might also have to get a service or supply approved ahead of time for the plan to cover it.
For many people, Medicare Advantage works out as cheaper thanks to the increased coverage and lower out-of-pocket costs. However, because everyone’s circumstances are different, it pays to shop around for a specific Medicare Advantage plan that best suits you.
There are five different types of Medicare Advantage Plans. You may benefit more from certain plans than others, depending on your situation. These are:
You understandably want to get the best service for your money, especially when it comes to your healthcare. The first thing to look out for is the star rating. Medicare uses member surveys, the plans themselves, and healthcare providers to collect data on certain plans. It then assigns a star rating from 1 to 5 stars, with 5 stars being the highest rating.
You should also consider the costs of your rating, including the plan’s premium and the maximum out-of-pocket cost. Remember that the cheapest option on paper might not always be the cheapest option for you, as it may not cover your healthcare needs. For example, if you see specialists frequently and don’t want to constantly make referrals, you’d want a different plan than a light health care user.
Your preferences also matter. For example, you may have a regular network of caregivers, healthcare providers, and medical facilities that you prefer to use, so a plan that includes them would be ideal.
Once you think you’ve found a plan that suits your needs, visit the provider’s website and make sure that you completely understand the benefits and limitations. You can even call the carrier if you have any questions.
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