Medicare Advantage Plans, are health plans from insurance companies that have a contract with CMS (Center for Medicare and Medicaid). People with Medicare Parts A and B are eligible to choose a Medicare Advantage plan. There are specialized plans for people with certain health conditions, but beyond that, general plans cannot decrease based on health, except for very specific reasons.
When a person joins the plan, they do not lose their Medicare. They have the right to cancel their Medicare Advantage plan and the following month they can return to Original Medicare. While they are enrolled in Medicare Advantage, they must use the insurance card provided by the Medicare Advantage plan instead of their Medicare card.
These plans may cost participants little or nothing, although many still require the Part B participation amount. A Medicare Advantage plan is not free, however. Plans receive a contribution from CMS each month, instead of tax dollars going to Original Medicare. This is how most of the plan is paid for, with tax dollars.
Traditionally, Medicare Advantage plans were considered HMO plans in which a member had to use the plan’s hospitals, doctors, and other medical providers to be covered. Many Medicare Advantage plans are HMO plans. However, there are also Medicare Advantage PPO plans. Medicare Advantage fee-for-service plans, or plans that will cover any medical provider that accepts insurance, are aggressively marketed these days.
Your own medical needs and preferences will determine which plan will work well for you. If your current medical providers contract with the plan’s HMO, then you can be very satisfied with comprehensive coverage with very few additional payments. If you want more choice and area doctors accept a free plan, then you might consider an “Any Doctor” plan. Keep in mind that not all doctors work with fee-for-service plans, although the insurance company claims it will work with any doctor! PPO plans provide a great commitment. You get the most coverage at the lowest in-network price, but you’ll still be covered by other medical providers.
Most, but not all, Medicare Advantage plans also contain Part D, or prescription drug coverage. Medicare Advantage plans may have a very low or no premium for members beyond their normal Part B premium. Some plans even refund the Part B premium. Also, Medicare Advantage plans can’t make a huge selection of risks based on health, so they may be a good option for less healthy applicants.
a traditional Medicare Supplement it is very different from Medicare Advantage. With Medicare Supplements, you still use your original Medicare Card and add your Medicare Supplement health card. These plans are also provided by insurance companies, but they simply fill in coverage gaps and deductibles not provided by original Medicare Part A and Part B.
If you have Medicare Part A and Part B, your Medicare Supplement plan will pay the part of your medical bill that Medicare won’t. Of course, Medicare Supplement plans differ, so you need to know exactly what parts a Medicare Supplement plan will pay for before you sign up. For example, Medicare may be 80% of your hospital bill and your supplement will cover the other 20%.
Medicare supplements come with premiums and may also exclude sick people. However, they generally provide the widest access to healthcare.