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Medicare Advantage & Things to Consider

A Medicare Advantage (MA) plan is a type of health insurance offered by a private company that contracts with Medicare and offers all Medicare Part A and B benefits. MA plans include health maintenance organizations, preferred provider organizations, private paid service plans, and special needs plans.

Advantages of the MA plan

  • Monthly premiums for most MA plans are low. Some have no monthly premiums.
  • Some plans may provide more benefits than your original Medicare covers.
Part C (Medicare Advantage) bundled plan administered by a private insurance company

Disadvantages of MA plan

  • The MA plan is an annual contract. Plan may choose not to negotiate or renew the contract.
  • Plans may change benefits, increase premiums, and increase out-of-pocket costs at the beginning of each year.
  • Your current doctor or hospital may not be your network provider or accept the plan's payment terms.
  • In most cases, you will not be able to maintain standalone Medicare Part D and Medicare Advantage plans.

Things to consider before purchasing a plan

  • Ask your healthcare provider if they accept MA plans.
  • Ask your future Plan, if you need a referral to see a specialist.
  • If you live in another state for part of the year, check to see if your plan applies.
  • Many plans require regular servicewithin a service area (excluding emergency medical care). This is usually the county in the state where you live.

Check if your plan includes:

  • Monthly costs
  • Co-payments for any and all services
  • what is the out-of-pocket limits
  • Fees for using non-network providers

With various parts, plans, and enrollment periods, the process can be overwhelming. That's where we come in. As your dedicated Medicare broker, we're here to break down the options for you,

Special Needs Plans:

If you have Medicaid, you are in long-term care, or live in a nursing home, there might be a special needs plansavailable in your area. If you choose any other type of MA plan, make sure:

  • Plan providers within your network are certified to accept Medicaid.
  • Providers in the network correctly charge plans and refer Medicaid providers as needed.
  • Your provider's office knows what Medicaid covers and what your plan covers.
  • Monthly premiums must be paid. Medicaid does not pay premiums for MA plans.

If you still have questions that were not answered or you need help finding a plan in your area. Schedule an appointment with Cosi Agency for a 1 on 1 appointment.

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