Medicare Advantage

Medicare Advantage Plan for Seniors

Medicare Advantage Plan

Are you considering a Medicare Advantage Plan? Seniors' Healthcare Solutions consults seniors throughout the Kansas City area to find affordable Medicare Advantage Plans that fits their health needs.

What Is a Medicare Advantage Plan?

Medicare Advantage Plan is another way for seniors to get Medicare Coverage in Kansas and MissouriIf you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies that Medicare approves.  

What Does Medicare Advantage Plans Cover?

In all types of Medicare Advantage Plans, you're always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care and some care in qualifying clinical research studies. Original Medicare covers hospice care and some costs for clinical research studies, even if you're in a Medicare Advantage Plan.

Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and other health and wellness programs. Most include Medicare prescription drug coverage (Part D).

How Much Does a Medicare Advantage Plan Cost?

Medicare pays a fixed amount for your coverage each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. 

However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to doctors, facilities, or suppliers that belong to the plan’s network for non-emergency or non-urgent care). 

These rules can change each year. The plan must notify you about any changes before the start of the next enrollment year.

Features of Medicare Advantage

  • May require in network doctors and hospitals
  • May need referrals and required to use network specialists
  • Emergency care is travel within the U.S. and sometimes abroad
  • Specific periods during the year for enrollment or plan switching
  • Typically pay a low or $0 monthly plan premium in addition to Part B premium.
  • When you use services, you pay co-pays, co-insurances, and deductibles
  • Prescription drug coverage included in most plans

What Are The Different Types of Medicare Advantage Plans?

Health Maintenance Organization (HMO) plans

In most HMOs, you can only go to doctors, other health care providers, or hospitals in the plan’s network except in an urgent or emergency situation. You may also need to get a referral from your primary care doctor for tests or to see other doctors or specialists. See page 82.

Preferred Provider Organization (PPO) plans

In a PPO, you pay less if you use doctors, hospitals, and other healthcare providers that belong to the plan’s network. You usually pay more if you use doctors, hospitals, and providers outside of the network.See page 83.

Private Fee-for-Service (PFFS) plans

PFFS plans are similar to Original Medicare in that you can generally go to any doctor, other health care provider, or hospital as long as they agree to treat you. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.See page 84.

Special Needs Plans (SNPs)

SNPs provide focused and specialized health care for specific groups of people, like those who have both Medicare and Medicaid, live in a nursing home, or have certain chronic medical conditions. See page 85.

HMO Point-of-Service (HMO POS) plans

These are HMO plans that may allow you to get some services out-of-network for a higher copayment or coinsurance.

Schedule Your Free Consultation Today

Not sure which Medicare Advantage Plan is best for you? Our Medicare Specialists offer free Medicare consultations to help you determine which plan provides the best benefits at an affordable cost. Contact us today to schedule a consultation.

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