Medicare Advantage is a way to get your Medicare benefits through private Medicare-approved insurance companies. These plans offer a bundled alternative to Medicare Part A and Medicare Part B coverage and often include extra coverage like Medicare Part D, dental, vision, and/or fitness and wellness programs.
When you have a Medicare Advantage plan, Medicare pays a fixed amount for your healthcare each month to the private companies that offer your plan. These companies are required to follow the rules set by Medicare, but these plans usually have different rules about how you access care and can charge you different out-of-pocket costs.
There are several different kinds of Medicare Advantage plans, each with different rules about how you access care:
- Health Maintenance Organization (HMO) Plans, where you usually need to get your care from providers within the plan’s network
- Preferred Provider Organization (PPO) Plans, where you pay less when you use in-network providers and hospitals
- Special Needs Plans (SNPs), which are limited to people with specific diseases or characteristics and tailor benefits for those groups of people
- Private Fee-for-Service (PFFS) Plans, which determines how much it will pay health care providers and hospitals, and how much you have to pay to get services
- Medicare Medical Savings Account (MSA) Plans, which have a high deductible and savings account to cover your healthcare costs
Is Medicare Advantage Right For Me?
Medicare Advantage plans use the power of networks of providers to keep your costs down while often still providing extra coverage (such as dental and vision). Medicare Advantage plans also usually offer you more coordinated care across providers.
When you choose a Medicare Advantage plan, you still pay your monthly Medicare Part B premium, and you may need to pay a premium to the private company that provides your plan, too (but not always). Some Medicare Advantage plans can offer a smaller deductible (or no deductible at all) and lower copayments, and all Medicare Advantage plans have a firm limit on your out-of-pocket Medicare costs. Original Medicare doesn’t have this limit, so this can be a huge benefit.
If you want a more coordinated care plan, extra coverage, an out-of-pocket maximum, and don’t mind limiting yourself to a specific network of providers depending on the plan you choose, a Medicare Advantage plan could be a good option for you.
Find The Medicare Plan That Fits You
At Simple Retirement Benefits, we worry about your benefits so you can focus on what’s really important: enjoying retirement. Our mission is to ensure you are properly informed on all things Medicare so you can make an educated decision on the coverage that best fits your needs. You can contact us today at 512-432-5414 to receive your free quote.
