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Medicare Advantage (Part C) plans are Medicare-approved medical insurance plans that you can get from private insurance companies. The advantage here is that you only have to get a single plan and it will provide you with the complete coverage you would get from Original Medicare (Part A and Part B)—except the hospice care that you would get with Plan A)—as well as other benefits at no additional cost.
These can include coverage for prescription drugs, routine visions, hearing, and dental care, telemedicine virtual visits, transportation costs, fitness center membership, and more. The benefits on offer can differ from state to state. For instance, the benefits you get with Medicare Advantage Plan Florida will not be the same as those you would get for a Medicare Advantage plan in Wisconsin.
Medicare Advantage Plans
When it comes to choosing among the best Medicare Advantage plans, you must select from the following four main plan types:
• Health Maintenance Organization Plans (HMO)
• Preferred Provider Organization Plans (PPO)
• Private Fee-For-Service Plans (PFF)
• Special Needs Plans (SNP)
There are also two other plan types:
• Point Of Service Plans
• Medical Savings Account Plans
Let’s see what these plans offer:
Health Maintenance Organization Plans (HMO)
With this plan, you must select a primary care doctor, and you must get this doctor’s referral when you need to see a health specialist. Your coverage will be only for the medical services you get from the Medicare providers that are on the HMO plan’s network.
Preferred Provider Organization Plans (PPO)
You don’t need to get your primary care doctor’s referral to see a health specialist with the PPO plan. You can see any doctor and get treated at any hospital. However, you will be able to pay less if you use the doctors and hospitals that are on the PPO plan’s network.
Private Fee-For-Service Plans (PFF)
As per the PFF plan, you don’t need to select a primary care doctor, and you also don’t need their referral to see any health specialist you want to see. However, that health specialist or any other Medicare provider may not accept the PPFS plan payment terms.
Special Needs Plans (SNP)
This plan covers those who live in nursing homes, have a debilitating chronic condition, and have Medicare and Medicaid enrollment.
Point Of Service Plans (POS)
You can see doctors and visit hospitals outside the plan’s network, but you will have to pay a higher co-payment or co-insurance.
Medical Savings Account Plans (MSA)
Medicare will deposit a certain amount in your savings account annually, and you can use that money to pay for your medical expenses.
Choosing Among the Best Medicare Advantage Plans
To choose a Medicare advantage plan, consider the following:
• Does the plan require your physician’s referral to see a health specialist?
• Does the plan allow you to see a health specialist without a physician referral and without paying the entire cost?
• Does the plan allow you to seek medical help from outside doctors and hospitals?
• If you have special needs, does the plan provide for those?
• Does the plan allow you to see any U.S.-based medical provider that accepts Medicare?
• Does the plan provide all the coverage that you would get with Medicare Part A and Part B, excepting hospice care?
• Does the plan provide additional coverage for services that Medicare Part A and Part B don’t cover?
For Medicare Advantage Plan Florida, check all the available plans for the following:
• The annual cost of each plan.
• Medicare’s quality rating for each plan according to customer satisfaction and quality of healthcare. Choose a plan that is rated 3.5 and higher out of 5.
• The plan’s co-payments and deductibles. Find out about the annual out-of-pocket limit. That is the figure you will have to pay for doctor’s visits, or hospital stays in a year. The plan will cover the rest.
• List of doctors and hospitals on the plan’s network.
• Dental and vision coverage.
• Travel coverage.
After considering the details of each plan, you will be able to make an informed decision about choosing one that can cover all your healthcare needs.