Medicare Advantage Plans in Southeastern CT
What are they?
A Medicare Advantage Plan (MA) covers all Medicare A & B treatment & procedures plus other benefits. A person goes to the plan's network of providers to receive treatment. These plans are part of what Medicare calls Part C.
The other benefits in a MA plan include annual physicals and options for or to buy coverage such as for dental, vision, hearing, and fitness.
When a MA plan includes medications, as most do, they are called a MAPD plan.
A look at MA plans:
● The benefits to be included in a MA plan are developed by private companies, submitted to MediCare, and when approved the company receives a yearly contract.
● Companies determine the States and Counties where they want to offer their plans. Individuals can select from the plans in their County.
● When a plan is purchased MediCare pays the company a fixed monthly payment for each person.
● Plans (usually ) have a monthly cost the amount of which varies primarily based on the co-pays and cost sharing plus the included benefits.
● MDs and other providers in the companies network bill the company for all of a person's treatments not the MediCare system.
● When a person enrolls all medical treatment and medications are coordinated which results in higher quality care and often better outcomes.
● Many people like MA plans because of annual physicals and extra benefits. Then too, having a lower monthly cost (often ) than a MediGap plan plus a stand alone Part D plan is a big plus.
● A recent study by the Better Medicare Alliance found — "individuals in private MA plans had:
> one-third fewer ER visits
> 23% fewer stays in a hospital
than those in traditional fee for service MediCare."
Ok! You are enrolled in a MAPD plan - what are your costs?
● Receive all your treatment from providers in the companies network.
● Pay a co-pay at each MD visit and often cost sharing for other services.
● Pay a per day fee for the first few days if in a hospital.
● Your annual co-pays, cost sharing, and other medical treatment costs are limited by the plan's Maximum Out of Pocket (MOP) provision.
Note: The MOP amount a plan may have is set each year by MediCare. ($6,700 in 2020) A plan with a higher monthly cost may have a lower MOP.
● Are limited [normally] to only changing to another plan or to another company during the 10/15 to 12/7 Annual Election Period.
Note: MAPD Plan enroll or change times are limited by federal regulations.
When can a change in MA plans be made?
● Normally changes to another plan or to another company are limited to the 10/15 to 12/7 Annual Election Period.
Federal regulations limit the times to enroll in or change a MAPD plan.
Learn more about Medicare Advantage Plans!
Call or Text John C Parker's Google Voice # — (860) 451-9793 today:
● If a qualified enrollment period is available discussion will be on:
-> your situation & interest
-> simplifying how Medicare Advantage Plans in New London County Connecticut work.
-> selecting a MAPD to provide peace of mind.
-> taking care of all implementation details.