A Medicare Advantage Plan (MA) covers everything MediCare does plus additional benefits. Some general points about MA plans:
● They are purchased from a private company which has a yearly contract with MediCare.
● Most MA plans include coverage for medications and are then called a MAPD.
● The company is paid a fixed monthly payment for each person who enrolls and manages all their medical treatment and medications.
● Providers bill the company for all of a person's treatments.
● Plans charge a monthly cost (usually ) which varies based on the amount of the individual's cost sharing.
● The plans available to a person are based on the County they live in. Some MA companies have plans in CT but do not offer all options or any in New London County.
● They cover, in addition to everything in basic MediCare, annual physicals and usually offer or provide options to buy benefits such as fitness, dental, vision, and hearing not in MediCare.
● All treatment is received from providers in the companies network and a co-pay is usually paid at each MD visit.
● Some services have cost sharing or a daily fee.
● A person's annual cost for co-pays and cost sharing is limited by a Maximum Out of Pocket (MOP) provision.
● MediCare sets the MOP limit each year. ($6,700 in 2019 ) Plans with a higher monthly cost may have a lower MOP.
● When plans coordinate all of an individuals medical treatment and medications it's a higher quality care and may mean better outcomes.
● A person can normally only change their coverage during the 10/15 to 12/7 Annual Election Period to be effective the next Jan. 1st.
Note: The times when a person can apply for or change their MAPD plan are limited by federal regulations.
● They are of interest to many because of the extra benefits and the 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 for an appointment to simplify the Medicare Advantage Plans in Southeastern Connecticut.
● Discussion (no cost to you ) will be on how they work, protect income & savings, and provide peace of mind.
● If a qualified enrollment period is available we can select a MAPD plans which fits your situation and budget best.
● All implementation details will be taken care of.
BTW - you can also send a note with questions to - Learn@JohnCParker.agency
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