The Basics of Medical Advantage Plans You Should Know

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Everyone in today’s world needs medical care at some point or the other. Medicare Advantage Plans are a type of health insurance plan which are offered by private companies that have contracts with Medicare. 

They provide clients with all Medicare Part A and B benefits. Medical Advantage or MA plans often include a broad spectrum of coverage, like healthcare maintenance organizations, private fee-for-service plans, preferred provider organizations, and Special needs plans. 

Medicare Advantage plans, which are also sometimes known as Medicare Part C, are required to offer the same medical benefits as Medicare Parts A and B. These cover hospitalization and doctor’s visits. They also typically cover Medicare Part D plans which include prescription drug coverage. Apart from these, MA plans could also offer benefits not covered by Medicare like routine dental care, eye care and glasses, hearing aids, and so on. 

The Difference between Medical Plans 

  • Medical Advantage and Original Medicare Plan 

Medicare Advantage plans sometimes have limitations on provider networks, and if individuals go outside their network, it could negate the coverage or increase costs significantly. If you stay with Original Medicare, you can use any doctor or medical facility which accepts Medicare assignments. 

However, you often pay much less for MA plans. You would still have to pay monthly coverage for Part B, but the additional costs of MA plans are still considerably less expensive than Medigap plans. At times, depending on the company offering MA, the plan may have a no-charge premium as well. These plans may also have a maximum cap for covered care, where the amount you’ll be expected to pay from your pocket is limited. 

  • Medicare Advantage Plan and Medigap

MA plans can be often confused with medicare Supplement Insurance, commonly referred to as Medigap. Both these plans are offered by private companies, but the expense coverage means differ. Medigap plans cover the gaps in the original medicare plan and cover your share of charges, usually up to 20%. When you receive medical care, most of your cost will be covered by the Medigap plan and you’ll pay a monthly premium for the same. 

MA plans in contrast are numerous different plans bundled together to give you the same coverage you’d get with Medicare Part A, B, and even D with limited coverage for other medical charges like dental or eye care. You may or may not be expected to pay a premium, but not beyond the Medicare Part B premium. 

How to choose the best MA Plan? 

When you compare numerous Medicare Advantage plans, you must first understand your own health care needs and check which plans offer coverage for your needs and lower your costs. 

Here are a few simple questions to ask yourself while evaluating your MA Plans: 

  1. Do you need a referral to see specialists? 
  2. What are the benefits the plans include? 
  3. Are all or most of your prescription drugs covered? 
  4. Which doctors are covered under your plan? 
  5. What’s the Medicare star rating for the plan? 

These questions can help you choose the best MA plan for you that saves you time and money.

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