What Should You Know About Medicare Advantage Plans?

Medicare Advantage Plans

Medicare Advantage Plans are a type of health insurance plan offered by the government to people who are eligible for Medicare. These plans can be very beneficial, but there are some things that you should know before enrolling in one. This post will discuss the basics of Medicare Advantage Plans and how they can benefit you. 

Who Runs and Regulates Medicare Advantage Plans?

Medicare Advantage Plans are offered and regulated by the Centers for Medicare & Medicaid Services (CMS). CMS is a federal agency that oversees the Medicare program. Private insurance companies contract with CMS to offer these plans such as the UnitedHealthcare plan.

Medicare then pays these insurance companies a set amount of money each month for each enrollee. The insurance companies use this money to cover the enrollees’ medical expenses.

Beneficiaries are still enrolled in Medicare and still have the same rights and protections as those who enroll in Original Medicare (Parts A and B).

You May Be Restricted To In-Network Providers

Medicare Advantage Plans are some of the most comprehensive healthcare plans you can find. However, there are differences in the benefits you can get from different Medicare Advantage Plans. 

One of the differences is that you will be restricted to in-network providers in some plans. If your plan does not cover treatment by out-of-network healthcare providers, you will have to choose a facility that is in-network. The same applies to drugs recommended. You have to stick to those recommended or you’ll have to pay out of pocket.

How Much Do Medicare Advantage Plans Cost?

You will have to pay a premium for the Part B of the Medicare plan. You will also have to pay a premium every month to access the services included in the advantage plan. Each Advantage plan has different premiums and costs for its services. You should compare programs and contrast the costs and benefits to find which one suits you best. It helps to plan for the future. 

Different Types of Medicare Advantage Plans

There are several types of Medicare Advantage Plans which include: 

1. Health Maintenance Organization (HMO) plan 

Unlike other plans where you can only visit a doctor or medical institution within your network, you can visit any medical facility if you have the plan. 

2. Preferred Provider Organization (PPO) plans

You pay significantly less for using doctors within your network in a PPO plan. You can still get healthcare from providers outside the network, it will just cost you a lot more.

3. Private Fee-for-Service (PFFS) plans

You can visit any healthcare provider with a private fee for service plans as long as they accept the plan’s payment terms. 

4. Special Needs Plans (SNPs)

Special needs plans offer specialized healthcare for people with special needs which may include people in nursing homes or with various chronic health conditions. 

HMO Point-of-Service (HMO POS) Plans

HMO Point of Service Plans allows you to get healthcare from an out-of-network healthcare provider but at a copayment or coinsurance rate.

Medical Savings Account (MSA) Plans

These plans will give you a high insurance deductible if you have a bank account. Medicare Advantage Plus Plan will deposit money into the bank account minus the deductible. You can then use the money to pay for healthcare services throughout the year. 

You will not get Medicare drug coverage with an MSA plan. You will have to join a Medicare Prescription Drug Plan to get the drug coverage. 

There is much you need to know about Medicare Advantage Plus plans. The information above is only meant to get you started. Scour the internet or contact the appropriate parties to learn what you need to know about the plans.


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