Medicare Many Advantage Plans have additional extra benefits

You have known for a while that once you turn 65, you will be eligible for Medicare. As the time gets closer, you start paying more attention when people talk about Medicare options. You keep hearing about Medicare, Medicare Advantage Plans and Medicare supplement policies, and now you are confused as to which one you need, and which one you are eligible for, and which one you get for free. These are all good questions.

Traditional Medicare has been around since the 60s. It is a federal government insurance program. American workers who have paid FICA (Federal Insurance Contributions Act) or self-employed taxes have been contributing to the Medicare program already. These persons, once they reach the age of 65 and become Medicare eligible, will be permitted to enroll in what is referred to as traditional Medicare Part A, which are hospital benefits. Part A typically covers 80% of major medical hospital charges, after the deductible has been met. Members will no t have to pay premiums for Medicare Part A. However, members will have to meet their deductible, and then be responsible for 20% of the medical hospital charges.

That is when Medicare supplement policies come in. A Medicare supplement policy is designed to fill in the gap in traditional Medicare coverage. There are many different types of Medicare supplement policies. At this time they are identified by the letters A through L, although M through P will be introduced in the coming years. Each of these Medicare supplement policy has a different combination of benefits, included services, premiums, deductibles, etc. Therefore, it is important that consumers shop around carefully to find which Medicare supplement policy will best meet their needs. Many of these Medicare supplement policies will also help cover prescription costs, which is Part D of traditional Medicare.

Different from a Medicare Supplement policy is a Medicare Advantage Plan. A Medicare Advantage Plan is a policy that serves just like traditional Medicare Parts A and B, but is purchased from a private health insurance provider, not directly from Medicare. It does not merely cover the gap, like a Medicare supplement policy, but serves the same purpose as a traditional Medicare policy. However, Medicare Advantage Plans will have additional extra benefits to members. Their costs are somewhat higher, between $40 and $75 more per month, which is why they offer additional benefits.

Those individuals who purchase Medicare Advantage Plans are not permitted to also purchase a Medicare supplement policy. This is because the Medicare Advantage Plan already includes extra benefits, and will already be helping members pay things that traditional Medicare does not cover. Therefore, only those older adults who are enrolled in traditional Medicare Parts A and B will need to purchase a Medicare supplement policy to help them pay their medical expenses.

It is recommended that if you have a serious health problem, travel a lot, or split time between two homes, you are better off with traditional Medicare and a Medicare supplement policy. This is because there are no network restrictions with traditional Medicare, and the Medicare Supplement policy will help you pay off the deductible and coinsurance. Medicare Advantage Plans do require members to see in-network physicians.

Open enrollment period for 2011 Medicare Advantage plans

The open enrollment period for Medicare Advantage plans and prescription drug plans is from November 15 to December 7. You can find hundreds of different plans across the country, with different co-insurance, deductibles and premiums so procrastinators will be doing themselves a favor by shopping early.

Approximately 11.8 million Medicare beneficiaries were already enrolled in Medicare Advantage coverage plans as of September 30. That amounts to almost a quarter of all the people enrolled in Medicare.

How Do Medicare Advantage Plans Work?

These plans are from private insurance companies that provide insurance for seniors and certain people with disabilities. These plans are subsidized by the government and the plans typic ally compete with extras not available in Original Medicare, such as dental, hearing or vision coverage. With the subsidies, their premiums were lower than standard Part B Medicare premiums, but subsidies have come under scrutiny. The federal government has frozen subsidies during performance evaluations. Some plans may earn bonuses, but under-performing plans face a loss of subsidies and that may result in higher premiums.

Most Medicare Advantage plans include prescription drug coverage that is comparable to Medicare Part D. Advantage plans are also typically managed care plans, such as a health maintenance organization (HMO) or a preferred provider organization (PPO) plans. You typically have to choose a primary care physician and see that doctor for a referral before you can see a specialist.

Your access to doctors, hospitals or other medical providers may be restricted to the plan's provider network, too. A few insurers do have what are known as Private Fee-for-Service plans, which may let you to see any doctor or use any Medicare-approved hospital. Such plans may have co-pay charges for doctor visits, but you wouldn't be required to select a primary care physician or get a referral in order to see a specialist.

All Medicare Advantage plans provide all of your Part A and Part B Medicare coverage, including emergency and urgent care coverage. The plans don't cover hospice care because Original Medicare will provide that coverage even after you enroll in one of the Medicare Advantage plans.

How Do I Join One Of The Medicare Advantage Plans?

Generally, you can join a Medicare Advantage plan if you have Medicare Part A and Part B and you live in an area where there is an Advantage plan that accepts new members.

If you are switching to a dif ferent Advantage plan, all you have to do is join the new plan and you will automatically be disenrolled from your old plan. You will not have any lapse in your coverage.

As long as you are enrolled in any of the Medicare Advantage plans, you do not need to buy Medicare Supplement insurance. In fact, it is illegal for anyone to sell you any of the ten Medigap policies if you are in an Advantage plan. The benefits offered by Medigap policies are covered by Medicare Advantage plans and Medicare Supplemental insurance will not pay for your Advantage coverage plan co-insurance, co-pays or deductibles.

What Do Medicare Advantage Plans Cost?

These plans have been inexpensive or even free in certain cases. With the freeze on government subsidies, you may see higher premiums, co-insurance or co-pay charges or reduced benefits. Medicare Advantage coverage plans must continue to provide all of the benefits that are available through Original Medicare, though.

Medicare sets certain rules that all Medicare Advantage plans must follow, but these plans may include co-insurance charges on durable medical equipment like wheelchairs, add co-pay charges to see doctors, set an annual deductible you must meet before your prescriptions are covered or raise your premiums.

The only way to be sure you have the best Medicare supplement and are getting the most out of Medicare is to take a serious look at all of the Medicare Advantage plans and Medicare Supplement plans available in your area.