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Living in the age when healthcare services is skyscraping, especially for senior citizens and retirees dealing with their day to day health ailments happens to be challenging. Thankfully with the presence of Medicare Advantage plans in Texas corresponding to the traditional Medicare facilities, elderly Americans are in much better shape these days. Being a potential Medicare beneficiary, if you’re still unaware of Medicare advantage plans, just by enrolling you in the scheme, you can make your healthcare plan more comprehensive and accommodating.
In essence, Medicare advantage plan refers to the facilities available under Part C, and is an optional way for being beneficial to access Original Medicare (Part A/ Part B) in addition to Part C. Notably, since the facilities under the plan are chiefly offered by private insurance companies certified by Medicare, often they provide extra benefits that not accessible under traditional Medicare. Once you get enrolled, by paying the premium amount without skipping it yearly once, you can keep the plan active through automatic renewal.
Types of Medicare Advantage Plans
Health Maintenance Organization Plans (HMO): HMO plans needs you to obtain healthcare services from providers available in your network. Several plans may require you obtaining a recommendation from your primary care physician to visit a specialist.
Preferred Provider Organization Plans (PPO): In general, PPO plans don’t need any kind of recommendation to see a specialist even outside the network and without the need of paying anything from your pocket.
Point Of Service Plans (POS): With POS plan you’re allowed to see hospice and doctors outside the network for certain specified care service.
Special Needs Plans (SNP): SNP plans are intended to offer beneficiaries of Medicare Advantage plans in Texas with a variety of healthcare like chronic diseases for people entitled for both Medicare and Medicaid and nursing home residents.
Private Fee-For-Service Plans (PFFS): PFFS plans facilitate beneficiaries to obtain healthcare services from providers throughout the US who accept the terms and conditions of Medicare payments.
Medical Savings Account Plans (MSA): MSA plans include a special savings account that can be used by enrollers to cover tax-free expenses.
Additional Medicare Advantage benefit plans:
Prescription Drugs Coverage
Nearly every Medicare Advantage plans in Texas offers coverage for prescription drugs under part D. For enrollers it’s essential to go through the plan documents to find medications that are covered since plans may vary among providers and plans.
Unlike traditional Medicare that doesn’t cover routine eye tests, checkup and prescription eye glasses except for certain restricted situations; now, prepared with Medicare Advantage benefits you can avail routine vision text, eye care, prescription eye glasses, as well as contact lenses.
A number of Medicare Advantage plans in Texas benefits beneficiaries with coverage of routine dental checkup twice a year, teeth cleaning service aside from restorative dentistry, like root canals, dental fillings, crowns, and dental bridge.
While routine hearing exam and supply of hearing aids are generally don’t come under Original Medicare, a number of Medicare Advantage benefits are designed with those services.
By enrolling you in Medicare Advantage benefits, you can avail gym membership, join a yoga class, access weight management counseling, and scheduled wellness services, which are not covered under normal Medicare.
Individual Need-Based Medicare Advantage plans
Depending on individual needs, with appropriate Medicare Advantage plans in Texas, you may available coverage for
Alternative therapies like acupuncture or chiropractic care;
Counseling to deal with life, depression, heartache in the individual as well as group sessions;
Management of critical medical conditions including diabetes, heart disease, Alzheimer’s and Dementia;
In-house safety devices like bathroom safety tools, counseling on safety measures that help lessen the risk of fall and injury;
Home meal delivery on a temporary basis for one month after a surgical session or hospital stay;
Access to telemedicine and transportation facility to get you to-and-fro your healthcare points;
Wigs for baldness following chemotherapy;
How IT Works
According to Federal rules, Medicare Advantage plans are expected to offer identical coverage available under Original Medicare, i.e., Part A and Part B, other than hospital care which is administered under Part A of Medicare. In general rule, the government pays a fixed amount towards the plan while your insurance company pays the balance of your healthcare cost. The program has been designed as per Medicare rules and regulations. Beneficiaries need to note carefully that annual limits and restrictions on supplementary Medicare Advantage benefit plans in Texas may require you to pay a certain portion of the expenses or add co-insurance amount while you access them.