Medicare Advantage plans are the newer products in Medicare. 

  1. This is called “Part C” of Medicare meaning…you have all the rights and protections of Medicare but you’re not in the Part A & B of Medicare. 
  2. With Advantage plans you don’t show the Medicare card to the Providers…only the Advantage card…they are paying the bills.
  3. Advantage plans come in many shapes and sizes: HMO, PPO, PFFS, SNP and these designs might drastically change each year. 
  4. These plans vary by State and County. The more populated counties will have greater selections and better pricing. 
  5. One aspect of these Advantage plans is to offer lower premiums than Medigap plans. There are some Advantage plans with zero premiums! You will have co-payments for each quantity of care given. 
  6. Think of Advantage plans as eating “ala carte”; you pay for everything you order. Think of Supplements as a Dinner where one price includes appetizer, soup, and desert.
  7. One very important aspect of Advantage plans is making sure you have a plan with an “out of pocket maximum.” This protects your finances should you have a health impaired year. Not all plans include this protection and a serious condition could be very costly.
  8. Medicare Doctor’s are not required to accept Advantage plans. If you have multiple doctors it is imperative to verify with each that they accept the plan. Nothing worse than getting an Advantage plan that your doctor doesn’t accept. When calling the doctor’s office ask for the “billing & insurance” person; they best understand this material. 
  9. Advantage companies contract annually with the government. Meaning these plans can/will change year to year. Don’t assume the wonderful plan you have this year will be as good next year. All this is determined by government funding: increases or decreases. 

Again, a competent agent is critical for understanding the nuances of these plans. I am here to serve you.

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