Amerigroup's history in the health insurance industry goes back to 1994. Ever since, they have been helping people find balanced medical coverage to meet their needs. Today, they offer Amerivantage plans. These Medicare Advantage plans offer even more benefits than Original Medicare. But are they the right fit for you?
What Is Medicare Advantage?
At 65, you'll be eligible for Medicare from the federal government. For most people, the first option they consider will be Original Medicare, or Medicare Part A and Part B. Original Medicare covers routine healthcare needs and hospitalization. If you enroll, your benefits will come directly from the government.
However, many people who sign up for Original Medicare find that these benefits alone are not enough to cover their healthcare needs. So, many beneficiaries end up supplementing their Original Medicare policy with a Medigap plan, or supplement insurance policy. Medigap plans come from private healthcare providers, and there are 10 Medigap plans to choose from laid out by the U.S. Government.
Of course, the complexity of deciphering the different Medigap policies and how they vary from one place to another (and one carrier to another) can be extremely overwhelming. That's why some people choose to disregard Original Medicare all together and keep things simple.
If you want a straightforward coverage option, Medicare Advantage might be right for you. You can sign up for a Medicare Advantage plan through a private insurance company. The government will then pay that company directly in exchange for covering certain benefits.
You will not lose out on anything by choosing a Medicare Advantage plan. That's because all Medicare Advantage plans must offer at least as much coverage as Original Medicare (Part A and Part B). But, the great thing about them is that they also bring in extra benefits.
For instance, many Medicare Advantage plans also cover dental, vision, and hearing coverage. Some also give you access to wellness programs. But, again, these plans come through private companies. So, it is very important that you compare the various plan carriers before making your decision. Amerigroup is one potential carrier to consider.
More than 7.7 million individuals trust Amerigroup for their healthcare coverage. Their history dates back to 1994 and, in the past 25 years, they have built a great reputation as a reliable organization. Its parent company is Anthem.
Anthem is even more well-known for providing health benefits across the country. It has multiple companies that, all together, serve more than 74 million people. More than 40 million people have a health plan backed by Anthem. In fact, more than 1 in 8 Americans receive coverage through a plan affiliated with Anthem.
This gives members of Amerigroup the confidence of knowing that a large, national company stands behind their coverage. But, Amerigroup prides itself on offering personalized care for each individual. This gives you the best of both worlds as you enjoy stability and accessibility along with tailored service.
Overview of Amerivantage Plans
Amerigroup calls their Medicare Advantage plans "Amerivantage" plans. However, the exact coverage and benefits of their Amerivantage plans will depend on your location along with various other factors. So, to see what's available to you, you can use their tool.
Types of Medicare Advantage Plans
The federal government keeps a close eye on the Medicare Advantage plans that private insurance companies offer. This ensures that you are, at the very minimum, always receiving the same coverage you'd get with Original Medicare directly.
However, no two Medicare Advantage plans are alike. The government allows private insurance companies to structure Medicare Advantage plans in various ways. This includes HMOs, PPOs, PFFS plans, and Special Needs Plans (SNPs). The structure of your plan will determine whether or not you can see out-of-network provides and the costs you will have to pay out-of-pocket.
In the case of Amerigroup, they only offer Amerivantage HMO plans. Other carriers may offer HMO plans alongside other plans, like PPOs, or they may not offer a HMO plan at all. It all varies depending on the carrier you select. That's why shopping around is important.
However, the fact that Amerigroup only offers HMO Medicare Advantage plans, that might make narrowing down your choices much easier. While HMOs are one of the most popular plan types, they are quite restrictive and they aren't the best fit for everyone.
Amerivantage HMO Plans
The primary reason why HMO plans are so popular is that they have some of the lowest monthly premiums of all plan types. That means you'll save money on the costs associated with your HMO plan, helping you score good coverage for less. However, there is good reason for HMO plans being cheaper.
HMO plans are the most restrictive of any plan type. The HMO plan you enroll in will have an established plan network. This network will contain a range of providers across the country. As a HMO enrollee, you will have to stay within this network in order to receive coverage. The only time a HMO plan will allow you to go out-of-network is in an absolute emergency situation.
Obviously, this can make for some major inconveniences and hiccups when it comes to receiving care. For instance, since you have to stay within the plan's network, you may have to choose a new Primary Care Physician (PCP) if the one you currently go to is not part of your plan's network.
Additionally, you will have to get a referral from your PCP before you can see any specialist. The specialists you go to will also need to be within the plan's network in order to receive benefits. This makes it difficult to get healthcare services when you are out of town or away from home. However, some HMO plans will cover you when you are travelling out of the country.
With all of this in mind, some people like the setup of a HMO plan. It is especially a good fit for individuals who do not need specialty care and only need coverage for routine visits. Plus, HMO plan may bundle additional coverage for dental, vision, and/or hearing care.
Knowing The Costs
Keep in mind that with any Medicare Advantage plan, you will still be responsible for a few different costs.
In addition to the monthly premium for your Medicare Advantage plan, you also need to continue paying the Medicare Part B premium. So, think about this when you are budgeting for your Medicare Advantage plan. In some rare situations, you may also have to pay a Part A premium, although most people do not.
Alongside the Medicare Advantage plan premium, your plan may also make you responsible for certain copays and coinsurance. You're also likely to have a deductible. You must meet this deductible before your plan begins covering the out-of-pocket portion of your care.
If you're on a tight budget, a HMO plan might be the right fit for you as it comes with the lowest associated costs of all the available plan types. Regardless, it is still important to look at all of your options.
Choosing The Right Carrier
Since Medicare Advantage plans come from private insurance companies, it's essential that you shop around. Failing to do so can end up costing you a lot of money out-of-pocket. That's because rates, coverage, and benefits vary from one carrier to the next.
Before choosing a plan, you should always speak to an agent at the company and ask for them to go over the Summary of Benefits with you. This is the document that explains all of the coverage details and benefits that come with a plan. Doing so will allow you to get a clear look at the costs and requirements you would have to abide by if you were to signup for the plan.
Of course, it's difficult to know who offers plans in your area. That's why Quick Medigap is so helpful. Just enter your zip code and you can view local carriers in under 2 minutes! With this fast and free tool, you'll be able to sort through your options quickly and find the plan that fits your needs.