A Medicare Advantage Plan (MA) is MediCare's Part C. Individuals who enroll use the plan's coverage instead of Medicare A & B. They also gain additional benefits not in original MediCare such as an annual physicals and usually receive or have options to buy benefits such as fitness, dental, vision, and hearing.
Some general points:
● MA plans are developed by private companies and when MediCare approves the benefits the company developed it receives a yearly contract.
● Companies determine the States and Counties where the approved plans will be offered. Availability to an individual is thus based on the County they live in.
● When a person selects a MA plan the company then coordinates all their medical treatment and usually medications. When a MA plan includes medications, as most do, they are then called a MAPD.
● When individuals purchase a plan MediCare pays the company a fixed monthly payment for each person.
● Plans (usually ) charge individuals a monthly cost which varies based on included benefits and the amount of the individual's cost sharing.
● Providers bill the company for all of a person's treatments not the MediCare system.
● Receive all their 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.
Pay treatment based co-pays, cost sharing, etc up to the plan's Maximum Out of Pocket (MOP) provision. Thus, a person annual cost is limited ($6,700 in 2019 ). The MOP is set each year by MediCare.
Note: Plans with a higher monthly cost may have a lower MOP.
● The coordination of all an individuals medical treatment and medications results in higher quality care and may mean better outcomes.
● A person can normally only change their plan during the 10/15 to 12/7 Annual Election Period. If they do the new coverage is effective the next Jan. 1st.
Note: The times when a person can apply for or change their MAPD plan are limited by federal regulations.
● Many people are interested in MA plans because of the annual physicals and extra benefits. MAPD plans monthly cost is (often ) more economical than a MediGap plan plus a stand alone Part D plan.
● A recent study by the Better Medicare Alliance found — "individuals in private MA plans had one-third fewer ER visits and 23% fewer stays in a hospital than those in traditional fee for service Medicare."
Call or Text John C Parker's Google Voice # — (860) 451-9793 today for an appointment to simplify how the Medicare Advantage Plans in New London County Connecticut work.
● Discussion (no cost to you ) will be on your situation and how they protect income & savings not just on plan details.
● If a qualified enrollment period is available we can select a MAPD plans which will provide peace of mind.
● All implementation details will be taken care of.
BTW - you can also send a note with questions to - Learn@JohnCParker.agency
The Medicare-Health-Plans-Southeastern-CT content is © 2018 to 2019 by John C Parker, RHU, LTCP - All Rights Reserved.
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