Medicare Advantage

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. In Idaho some plans are very Network oriented, meaning you are limited to where your go for care and others are mor open network giving you more care choices. Medicare Advantage plans are limited to car in Idaho and some offer limited outside of Idaho coverage, Below are the most common types of Medicare Advantage Plans.

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNPs)

Medicare Advantage plans normally have a full assortment of other benefits such as Dental, Vision, Hearing, Fitness Center memberships, OTC allotments, Travel to and from Doctor appointment or Pharmacy etc. These benefits vary by plan and are often a selling point to some folks.

Rules for Medicare Advantage Plans

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different out-of-pocket costs. They can also have different rules for how you get services, like:

  • Whether you need a referral to see a specialist
  • If you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care

These rules can change each year.

Most Medicare Advantage Plans include prescription drug coverage (Part D). …Medicare.gov

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