A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits, with a few exclusions, for example, certain aspects of clinical trials which are covered by Original Medicare even though you’re still in the plan. Medicare Advantage Plans include: • Health Maintenance Organizations (HMO) • Preferred Provider Organizations (PPO) • Private Fee-for-Service Plans (PFFS) • Special Needs Plans • Medicare Medical Savings Account Plans.
If you’re enrolled in a Medicare Advantage Plan: • Most Medicare services are covered through the plan • Most Medicare services aren’t paid for by Original Medicare
• Many Medicare services require prior authorization • Most Medicare Advantage Plans offer prescription drug coverage.
• Most Medicare Advantage Plans have specific networks for providers and facilities.
What to look at when choosing a Medicare Advantage Plan?
At WC Insurance Solutions, we start looking for a plan by finding out what is most important to each client. Generally, the plan we suggest has all (or most) current providers, facilities, hospitals, and pharmacies in the network, and offers the most beneficial copay for all medications prescribed. In addition, we review the monthly plan premium, deductibles, and annual maximum out of pocket limit. After all this is considered, we then review the plans' extra benefits such as: vision, dental, hearing, fitness programs, and over-the-counter credits.
Medicare Advantage Open Enrollment Period (OEP) is from January 1 – March 31 each year. If you’re enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time. If you enroll within the month of January, the new plan would be effective February 1, and likewise for February and March enrollments.
OEP is happening NOW! Call WC Insurance Solutions for your Medicare Advantage Plan review, there is no cost and no obligation to change plans.
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