Medicare Advantage offers subscriber services that incorporate the Part A and Part B insurance basic benefits. In addition to this, it helps you receive extra care, such as getting regular health check-ups for general wellness, paying for hearing aids, dental services, and vision care in that you can get prescription glasses; moreover, this plan covers all your prescription drugs. For this plan, Medicare gets to partner with private insurance providers. Having such a comprehensive Medicare Advantage 2021 saves you money as you are spared of going back to your pocket to fund your health needs.
There are a few things that you need to know about this cover. These are:
- You are still in the Medicare program when in this plan, and you still enjoy Medicare’s rights and protection.
- It is very cost-effective as your out-of-pocket expenses are drastically reduced
- It is an annual plan, and you may only be able to join a particular plan at certain times of the year.
- You are not restricted to join this plan even with any pre-existing condition apart from End-Stage Renal Disease (ESRD).
- You can maintain low costs by seeing an in-network service provider. It also ensures that the insured services are covered.
- Some costs may be covered by your plan when you join a research study.
- The Medicare Advantage plan is banned from charging more than Original Medicare for some services like dialysis, skilled nursing, and chemotherapy.
In addition to all the benefits that Medicare Advantage Plan offers. It has some limitations. These are:
- You may experience an issue with the freedom of choosing the desired health provider. With the Advantage Plan, you are only required to see providers within your network, whereas in Original Medicare, you can walk into any facility and receive care.
- An Advantage plan limits you to a specific area.
Medicare Advantage Plans Include:
- Health Maintenance Organization (HMO): Prescription drugs are covered within this plan. However, they recommend that you get services from health and service providers that they have within their network. Going outside of the network can be costly.
- Private Fee-for-Service (PFFS) Plans: This type is offered by medical insurance companies. This plan sets how much you should pay, the amount to pay the doctors, hospitals, and other service providers. With this plan, you can go to any Medicare-approved provider or any other hospital that agrees to their terms as not all will. With this, you need to verify that your preferred plan covers prescription drugs.
- Preferred Provider Organization (PPO): They have network doctors, hospitals, and other health care providers. You get to pay less when you visit these providers, and they offer prescription drugs in most cases.
- Special Needs Plans (SNP): They confine membership to people with special characteristics or needs. The plan fashions benefits, providers, and drug formulas these groups. Within this plan, you are also restricted to a network of service providers except in emergency cases or if you have End-Stage Renal Disease (ESRD), and you require out-of-area dialysis.