Medicare is the United State's single-payer health insurance program for people over the age of 65, and others with certain medical conditions. There are four different parts to Medicare: A, B, C & D. Another name for Medicare Part C is Medicare Advantage. It combines Medicare Parts A & B in a plan from a private insurer. Curious what it is and how to get a Medicare Advantage plan? Keep reading!
Medicare Advantage Defined
If you see the terms Medicare Advantage, Medicare Part C or MA Plans, they are all referring to the same thing: Medicare Advantage. The plans are a bundle from a private insurer consisting of Medicare Part A - hospital coverage, and Medicare Part B - medical coverage.
These MA Plans cover everything that "regular" Medicare covers, but they may have optional additions for things typical Medicare plans lack like hearing, vision or dental coverage. Some plans even offer international healthcare coverage making it perfect for travelers. The cost of your Medicare Advantage plan varies depending on the options offered by your insurance company.
Why do people get Medicare Advantage plans instead of regular Medicare coverage? Well, they tend to feature lower spending caps and can even have lower premiums, especially if you get a plan that has Medicare Part D for prescriptions drugs too. While you could end up paying a few hundred dollars in premiums on regular Medicare, the average Medicare Advantage premium is just under $30/month in 2018.
Types of Medicare Advantage Plans
There are several types of Medicare Advantage plans that mirror what you are used to seeing for your regular insurance options.
HMOs (Health Maintenance Organization) require you to go to their facilities and use their doctors only. This is great for people who like to stay close to home because most HMOs are regional, and sometimes have a total lack of coverage for out of network care. You may need a referral to see a specialist with an HMO, but these plans are often cheaper than other types.
Another option is a PPO (Preferred Provider Organization), which has participating doctors in a network for you to choose from. You can get some coverage for care outside the network, but it costs more. This latter option is a bit more flexible for some if there are enough providers in your network.
PFFS (Private Fee for Service) is a unique insurance model that is only for Medicare plans. With a PFFS Medicare Advantage plan, you can see any provider who takes Medicare and accepts all the terms of your particular plan.
MSA (Medical Savings Account) plans are similar to HSA (Health Savings Account) in regular insurance. These plans have two components. You have a high-deductible insurance plan, but then the insurance company itself puts money into a medical savings account for you each month. You can use this money to pay for medical expenses whether or not they are covered by Medicare, and the money is all tax-free.
Prescription Drug Coverage With Medicare Advantage
Medicare Part D is specifically for prescription drug coverage. Many Medicare Advantage plans include Medicare Part D, but some do not. Double check whichever plan you choose to see whether or not it does. You could invalidate your Medicare Advantage coverage by trying to sign up for Medicare Part D if you already have drug coverage. If your plan doesn't include any prescription coverage, then you will need to sign up for Medicare Part D separately.
How to Sign up for Medicare Advantage
Signing up for a Medicare Advantage plan might seem confusing, but it is actually quite easy. Your enrollment period starts 3 months before you turn 65 and ends 3 months after the big day. Then, each year there will be an open enrollment period of about two months during which you can make changes to your plan or pick something different entirely. There are a few other qualifying events that could make you eligible for Medicare Advantage even if you are not 65 years old yet. If you have been on disability for 21 months, or you have ALS, you can also typically enroll in Medicare.
You can enroll or change a Medicare Advantage plan anytime you have a "qualifying life event." Examples include moving to a new area, losing your current coverage or your current plan dropping out of the Medicare Advantage program.
When you're ready to sign up for Medicare Advantage, search for the plan you want online at Quick Medigap, then sign up.
The Bottom Line
Medicare Advantage is a great way to save money when you are ready to sign up for Medicare. It makes signing up a breeze since you typically sign up for hospital, medical and drug coverage all at the same time. Find out more about your Medicare options at Quick Medicare.