Some Medicare Advantage Plans have gotten a bad rap lately, but that may have been because of the overzealous marketing efforts of a few people, rather than the actual plans. All Medicare Advantage plans must be approved by the Center for Medicare and Medicaid (CMS). They must provide services that are equal to, or better than, services provided by the traditional Medicare Part A and Part B. Of course, the point of these plans is to provide services that will provide advantages over Part A and Part B!
What is the Problem With Medicare Advantage?
The recent flak over Medicare Advantage Plans is over the type of plan called PFFS (Private Fee For Service). These plans allowed access to "any doc", or the enrolled person's choice of Medicare care. The problem there was that the doctor or other medical provider had to accept and bill to the plan. Since some of the plans were very new, medical providers like doctors, hospitals, and therapists did not have the plans yet. This caused problems because the enrolled people needed to file the bill with the insurance companies instead of having the medical provider do it. Indeed, this did cause problems for many Medicare recipients.
What about other Medicare Advantage Plans?
Medicare Health Maintenance Organizations (HMO) and Medicare Preferred Provider Organizations (PPO) have been around a long time. Both of these types of Medicare Advantage plans use networks of doctors and other medical providers that have already agreed to participate in the plans. As long as plan members use their identification card, they are not experiencing a lot of billing problems. In general Medicare PPO and HMO members are expressing great satisfaction with their health plans.
A combination of private competition and federal incentives allow private plans to offer health plans that do deliver quality health care and save Medicare recipients money. The networks, once thought to be restrictive, actually ensure that medical providers understand and agree to the system so that system works more smoothly. These plans usually include the Part D or prescription part of Medicare too!
Who is Happiest With Medicare Advantage Plans?
Medicare Advantage plans appeal to people with moderate incomes. Medicare supplements can be a burden for seniors and disabled people on fixed incomes. However, many seniors with larger incomes also participate in Medicare Advantage plans because they come from the same companies that used to carry their old group or individual health plans, and they are comfortable with the medical providers in the network!
Medicare Advantage plans also provide satisfaction to those with specialized or chronic needs. Plans are available that address chronic conditions such as diabetes or heart problems, or those in nursing homes. Some plans even address the needs of caregivers!
You have choices about how to get the most out of your Medicare benefits!
M Katz is a licensed Texas insurance agent, who has been certified to work with many Medicare Advantage Plans. In her experience, the vast majority of her clients who chose Medicare Advantage plans or Medicare Supplements with traditional Medicare were satisfied because they chose the right plan for their own needs.
We have helped thousands of seniors and disabled people make the most of their Medicare benefits. If have questions about Medicare Benefits, consult with the Medicare Health Plan Experts at Trusted Senior Specialists Medicare Plans!
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