What is a Medicare Advantage Plan?
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A, Part B and often Part D benefits.
Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare.
Most Medicare Advantage Plans also offer prescription drug coverage.
A DSNP (Dual Eligible Special Needs Plan) is a type of Medicare Advantage plan designed for people who are full benefit dual eligible for both Medicare AND Medicaid. The Medicare Advantage plan coordinates care with Medicaid to eliminate out of pocket costs and the plan offers extra benefits like dental, vision and increased over the counter benefits.
What do Medicare Advantage Plans cover?
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care.
Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.
You can also ask the plan for a written advance coverage decision to make sure a service is medically necessary and will be covered. If the plan won't pay for a service you think you need, you'll have to pay all of the costs if you didn't ask for an advance coverage decision.
Contact us to learn more about the right Medicare Advantage plan for you.
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