Medicare Advantage Plans are no doubt more advantageous to seniors than the traditional fee-for-service program. But many seniors believe they have an advantage over their doctor or hospital because their insurance company pays much of the bill. Medicare Advantage Plans pays 100% of the bill except when they do not have enough money to cover the bill. This is especially true for the elderly. This is why many providers of these plans prefer them to traditional fee-for-service plans.Most service providers that do accept Medicare Advantage Plans are primarily private companies that have websites on the internet. They provide a variety of different benefits packages to select from, which may include hospitalization, rehabilitation, medical transportation, preventive and specialty care, long-term care, medications, and vision care.
Plan coverage varies widely depending on the type of plan. Check with your provider for details. You may find a good provider that does not offer the plan you are looking for.There are many differences between traditional fee-for-service plans and Medicare Advantage Plans. The benefit plans have their own plan benefits and service fee schedules, deductibles, coinsurance, co-insurance, and out-of-pocket maximums. These differences make it confusing and difficult to compare plans.The biggest difference between these plans is the amount of income that they help subsidize. Traditional Medicare only helps with some of the costs; Advantage plans help with all of the cost. Medicare is more limited in terms of the services it covers and how much the Medicare payment is. Advantage plans cover every aspect of healthcare.
Like all insurance plans, there are deductibles that must be paid before the insured can receive the actual medical procedure. They also require a co-payment before receiving a procedure. Traditional Medicare has no co-pay or deductible; Advantage plans are the same.Traditional Medicare covers no doctor’s office visits and covers only outpatient care. For an outpatient visit, traditional Medicare usually requires a co-payment of 30%. Advantage plans cover a wide range of services including emergency room visits, emergency room care, doctor’s office visits, prescriptions, prescription drug refills, and physician and clinical diagnostic laboratory services.
There are generally two plans – Point-of-Service and “net-price” Medicare Advantage Plans. The difference between these two plans is that the latter requires a monthly payment for the total health care services in order to qualify for a plan; the former does not.If a patient has a Plan C, or a Point-of-Service Plans, Medicare will pay 100% of the fee for their care. If a patient has a Point-of-Service Plans, Advantage Plans will pay the entire cost of the procedure; while Medicare will pay only the charges that Medicare has agreed to cover.
When a patient’s case is complex, the best choice is often to ask your doctor to refer you to a Medicare-approved doctor and have them call your insurance company to submit your claim. Medicare will process your claim much faster. Call your insurance company for information.Some hospitals and physicians that are included in your Advantage Plan may not be in your network hospitals. In order to ensure that your stay is covered by your Medicare Advantage Plan, you should familiarize yourself with the different plans and providers. If you have additional questions about your Advantage Plan, you should always check with your insurance company’s website for answers. If you need Medicare Advantage plans in 2021 visit http://www.medicareadvantage2021.org