Medicare Advantage Plans Explained.
Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans provide your Medicare Part A and Part B benefits and many plans also include prescription drug coverage and additional benefits.
One Plan Can Combine Several Types Of Coverage.
Medicare Advantage plans replace how you receive your Original Medicare Part A and Part B benefits while you remain enrolled in Medicare.
Hospital & Medical Coverage
Medicare Advantage plans provide your Medicare Part A and Part B benefits through the private plan.
Prescription Drug Coverage
Many Medicare Advantage plans include Medicare Part D prescription drug coverage.
Additional Benefits
Some plans may include benefits such as dental, vision, hearing, fitness or other services. Benefits vary by plan.
The Details Matter More Than The Advertisement.
Medicare Advantage plans can differ in networks, prescriptions, costs and benefits. A plan that works well for one person may not be the best fit for another.
- Primary care doctors
- Specialists
- Hospitals and facilities
- Prescription medications
- Pharmacy networks
- Copays and coinsurance
- Maximum out-of-pocket limits
- Plan benefits and coverage rules
Provider Access Can Work Differently By Plan Type.
Medicare Advantage plans may use different network structures. Two common types are HMOs and PPOs.
HMO Plans
HMO plans generally require you to use providers in the plan’s network for non-emergency care, except in limited circumstances. Some plans may also require referrals for certain specialists.
PPO Plans
PPO plans generally allow you to use both in-network and out-of-network providers that accept the plan, although out-of-network care may cost more.
Check Your Medications Before Choosing A Plan.
If a Medicare Advantage plan includes Part D coverage, the plan has its own formulary, drug tiers and pharmacy network.
Reviewing your actual prescriptions can help you compare expected drug costs and identify whether your preferred pharmacy participates with the plan.
A $0 Plan Premium Does Not Mean $0 Healthcare Costs.
Some Medicare Advantage plans may have a $0 additional monthly plan premium, but you can still have healthcare costs when you use services.
Copays
You may pay set copays for services such as doctor visits, specialists or hospital care.
Coinsurance
Some services may require you to pay a percentage of the allowed cost.
Maximum Out-Of-Pocket
Medicare Advantage plans include an annual maximum out-of-pocket limit for covered Part A and Part B services.
Compare Plans Using Your Doctors And Prescriptions.
Parker County Medicare Advisors can help review Medicare Advantage plans available in Parker County and nearby North Texas communities.
We can compare provider networks, prescriptions, premiums, out-of-pocket costs and plan benefits based on your situation.
What To Have Ready
A current list of your doctors, prescriptions and preferred pharmacies can make a Medicare Advantage comparison much more useful.
Want Help Reviewing Available Plans?
Request a no-cost consultation with Parker County Medicare Advisors and review the details that matter to you.