To say that Medicare can be confusing is probably the understatement of the year.
To help get you started in the process of signing up for Medicare, let’s take a look at Medicare Part C, which is also known as the Medicare Advantage Plan. In the process, you’ll learn a bit more about Parts A, B and D and will be able to select the ideal coverage for your lifestyle.
Medical Advantage Plans 101
You’ve probably heard about the concept of bundling when it comes to your home, auto and/or life insurance. Medicare Advantage Plans, or Part C, also use bundling to give you Medicare Part A and Medicare Part B, and usually Medicare Part D. In general, Part A provides inpatient/hospital coverage, Part B provides outpatient medical insurance and Part D deals with prescription drugs. As Medicare.gov notes, these Medicare Advantage Plans are an “all in one” alternative to Medicare, and they are offered by private companies that are approved by the Medicare organization.
Not All Medicare Advantage Plans are the Same
Now that you know that Medicare Advantage Plans are basically a bundled Medicare plan, it’s important to also realize that they are not created equally. For instance, some offer extra coverage on top of the Medicare services, like vision, hearing and dental coverage. Part C plans can also have different out of pocket costs, and they may have different rules for things like referrals to specialists. There will also be limitations on your yearly out-of-pocket costs, and premiums can be tailored to fit your retirement budget.
Most Common Types of Medicare Advantage Plans
The majority of Medicare Advantage Plans fall into one of the following categories: these are Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Special Needs Plans (SNPs), and Private Fee-for-Service (PFFS) Plans. If you like the idea of bundling together a plan that is more specific to your health needs, it is important to learn more about these four options.
To make this process as easy as possible, consider comparing a company’s Medicare Advantage Plans side by side. This way, you can easily compare and contrast the pros and cons of each one. For example, as part of your comparison, consider the three criteria Anthem uses to compare it’s Medicare Advantage plans:
- What providers can I see?
- Will my out-of-pocket costs be high or low?
- This plan may be right for me if [use your research to fill in the blank].
According to Anthem’s chart, an HMO Medicare Advantage Plan will mean getting most of your care from a network of providers, unless it is an emergency. HMO plans tend to cost less than PPO plans and they can be a great option for people who don’t mind receiving care from a physician in the network. On the other hand, the PPO Medicare Advantage Plan also has a list of providers, but you can also choose to see someone who is out of the network. You don’t need a referral to see a specialist, but the cost of a PPO does tend to be higher. If you have a specific health issue, you might find that the Special Needs Plan is your best bet; this plan specializes in certain health conditions and they can also be lower in cost to help those who are already battling on ongoing medical issue. Finally, a Medicare PFFS Plan is offered by private insurance companies; the plan will determine how much it will pay your physician and hospitals and how much you must cover.
Medicare Part C Can Be a Solid Option
Medicare Advantage Plans, or Part C, can be a cost-effective option for older adults who like the idea of an all in one plan for their medical care insurance needs. Now that you know that they are not exactly the same, you can choose the plan that is best for you and your needs.