The scope of Medicare Advantage Part C

Although Part C should cover all necessary medical services provided by Medicare, your Advantage Plan may not cover all other services. Before performing any procedure, call your provider and request that your plan provide a written statement as to whether or not the service is covered. These decisions can be appealed. However, there are also Medicare Advantage PPO plans. Medicare Advantage plans, or plans that cover any medical provider accepting insurance, are being aggressively marketed today. Insurance companies offering Medicare Advantage plans participate in a family ritual each fall. In early October, they present their plans for next year. It is also time, if plans are not renewed for the following year, that notices are sent to plan members, informing them of the status of their plan renewal and detailing available options.

If your Medicare Advantage plan is not renewed by 2019, there are a few things to remember and several steps to take to ensure proper protection next year. Before making a decision, you should explore your options in depth with an agent who can help you navigate this complicated maze of insurance. Plans must meet certain criteria and in many cases offer benefits beyond conventional Medicare. You may still have cost sharing, but it is in the form of deductibles, copays and coinsurance. Plans usually include a maximum disbursed expense. Advantage plans usually include coverage for Part D prescription drugs. Many Medicare Advantage plans are free.

Medicare Advantage plans were traditionally thought to be HMO plans that an insured person had to use the plan’s hospitals, doctors and other medical providers to be covered. Many Medicare Advantage plans are HMO plans. Understanding the realities of the state of renewal of your plans and knowing what steps to take can give you the peace of mind to make an informed decision for the coming year. With changes affecting Medicare Advantage plans, including reduced fees and mandatory loss rates, fewer benefits will be offered to Medicare Advantage members. As an example, you may pay less for a Medigap plan than for a Medicare Advantage plan if you choose the N. Medigap plan. In addition, Medigap Plan N will have no network restrictions, restricted enrollment periods, or direct hospital expenses. It is among other features. However, keep in mind that Medigap does not include prescription drug coverage while Medicare Advantage plans exist. With a Medigap plan, you must acquire independent Part D prescription drug coverage.