Medicare Advantage is an optional addition to Original Medicare. It is essentially an all-in-one Original Medicare alternative that provides additional benefits.
There are a lot of perks to Medicare Advantage and a lot of things you need to know before signing up for a plan. So, to help get you started, here is everything you need to know about Medicare Advantage and what it has to offer.
How Does Medicare Advantage Work?
Medicare Advantage works similarly to traditional healthcare as you likely know it. Essentially, Advantage plans offer Medicare beneficiaries the option to have a private insurance plan, while still receiving the full benefits of Original Medicare.
As long as you’re already enrolled in Original Medicare, you are eligible for an Advantage plan. Overall, these plans offer a different method of organizing your care and the amount you pay for certain additional services.
The Cost of an Advantage Plan
Of course, all specific costs and additional benefits depend on the plan and provider you choose. Generally, however, you can expect to have to pay 3 different fees:
A premium is a monthly fee you must pay for continued coverage, regardless of the benefits used any particular month. You must also meet a yearly deductible before you can use any said benefits. Finally, for each service you use covered by your plan, you will have to pay a flat fee or a percentage contribution known as a copayment and coinsurance, respectively.
The good news? There are a lot of different plan and provider options on the market for you to find a payment method and amount that works for you. Many plans, for example, will offer little-to-no premium rates in exchange for a higher yearly deductible.
On top of this, you can easily determine your out-of-pocket costs with an Advantage plan by asking about its out-of-pocket limit. Prior to meeting this limit, you will have to pay your share of the copayment/coinsurance. Any services used after meeting the limit will be paid in-full.
Medicare Advantage Plan Options
Regardless of the provider you choose, you will have 4 basic plans to choose from. Each of these options will provide different payments, benefits, and ways of receiving care. These plans include:
- Special Needs Plans (SNPs)
- Preferred Provider Organization (PPO) Plans
- Health Maintenance Organization (HMO) Plans
- Private-Fee-for-Service (PFFS) Plans
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