Medicare Advantage - Part C
WHAT IS A MEDICARE ADVANTAGE PLAN?
Medicare Advantage Plans (Part C) typically combines Original Medicare (Parts A&B) into one single health plan. Private insurance companies contracted by CMS provide a Medicare benefits package as an alternative to Original Medicare. At a minimum, Medicare Advantage plans must include all Original Medicare (Part A&B) coverage (excluding hospice care). Advantage plans also include a variety of extra services that vary by insurer. Added benefits can include vision, dental, hearing, free gym memberships, free meals, give backs in your social security, low premiums, low co pays, over the counter allowance and more.
Medicare Advantage is optional, but in order to enroll, you must have Original Medicare (Parts A&B). If you enroll in a Medicare Advantage plan, you will continue to pay your Part B premium in addition to your Advantage plan premium. Advantage plan premiums vary anywhere between $0 to $100 a month.
Prescription drug coverage is typically included in the Medicare Advantage plans, but not with all.
Our agents are contracted with almost every local insurance provider in the Hudson Valley. We run a comprehensive analysis of your individual medical needs to help you make the best decision of what plan best suits your needs.
WHAT DO MEDICARE ADVANTAGE PLANS COVER?
- Dental Benefits
- Vision Benefits
- Hearing Aids
- Foot Care
- Telehealth & Virtual Services
- Over the Counter benefits
- Fitness Program
- Worldwide Coverage for Emergency Care services
- Prescription drug coverage (Medicare Part D)
How Is Medicare Advantage Different From Original Medicare?
Medicare Advantage Plans (Part C) include Parts A and B of Medicare, and many also provide prescription drug coverage (Part D) and other benefits not available under Original Medicare. As a result, roughly 26 million of the approximately 64 million people who applied for Medicare chose Medicare Advantage plans.
Original Medicare consists of Parts A and B. Part A covers inpatient medical requirements such as hospitalization, home care, and other inpatient medical needs. Part B covers outpatient treatment, including doctor visits, medical testing, screenings, and preventive care.
Many individuals may require additional health-care coverage. Original Medicare does not cover prescription drugs. Private insurers offer Medicare Part D coverage, but there may still be areas of your healthcare where you want protection. This is where Medicare Advantage can fill that gap.
CALL US TODAY TO LET US WALK YOU THROUGH YOUR OPTIONS TO MEET YOUR SPECIFIC NEEDS
Medicare Advantage Plans We Offer
HMO
Health Maintenance Organization
Except for emergencies and out-of-area urgent care and dialysis, Medicare Advantage HMO plans do not allow as much provider freedom as a PPO. In rare situations, you may be permitted to utilize out-of-network providers, but you will be responsible for the entire cost of the services.
Under an HMO plan, you must select an in-network primary care physician (PCP) and obtain a recommendation for in-network specialist visits.
PPO
Preferred Provider Organization
Medicare Advantage PPO plans allow some provider freedom at a greater cost for those that need it.
PPO plans cover providers, physicians, and hospitals both in-network and out-of-network. You will pay less for in-network providers' services and more for out-of-network providers' services. A PPO plan does not require a referral of a primary care physician (PCP) for specialist appointments.
D-SNP
Dual Eligible Special Needs Plans
Dual Eligible Special Needs Plans (D-SNPs) enroll people who are eligible for both Medicare (Title XVIII) and Medicaid medical assistance (title XIX). Some Medicare expenditures are covered by states, depending on the state and the individual's eligibility.
Is A Medicare Advantage Plan Right For You?
YES
- You’re enrolled in Original Medicare (Parts A and B).
- You’d like to keep premiums and copays as low as possible.
- You want to combine medical and prescription coverage in one easy plan.
- You want benefits Original Medicare doesn’t cover, such as dental and vision.
NO
- You’re enrolling separately in Medicare Part D for prescription drug coverage.
- You have coverage from an employer that pays all or some of the costs that Original Medicare doesn’t cover.
- You have coverage through your union that pays all or some of the costs that Original Medicare doesn’t cover.
- You’re going to sign up for a Medicare Supplement plan (Medigap) .
Other Parts Of Medicare
Frequently Asked Questions About Medicare Advantage Part C
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