Medicare Advantage

Medicare Advantage (MA) is also referred to as Medicare Part C. It is part of the Medicare program offered to disabled adults and senior citizens who qualify. Private insurance firms offer Medicare Advantage. This plan usually includes the medical coverage Part A, B, and D that Medicare offers.

How Does Medicare Advantage Work?

Medicare Advantage is considered a great alternative to Original Medicare because it covers all the costs incurred under Original Medicare. There are certain MA plans that cover extra costs not paid for by Medicare, including hearing, dental, and vision expenses. However, MA plans don’t work with Medicare Supplement and Medigap Insurance.

In 2020, the average premium for a MA plan is expected to be around $23. Private insurance firms receive a set amount of money every month for MA plan care. The insurance companies, in turn, charge out-of-pocket costs to policyholders. This also allows them to create their own rules for services such as the provider networks for both emergency services and non-urgent care.

Regional Preferred Provider Organization (PPO) was created to offer those in the countryside better access to MA plans and cover the whole statewide and multi-state regions. In 2019, regional PPOs accounted for about 6 percent of all MA enrollees. About 34 percent of the people that receive Medicare benefits were enrolled in the MA plan, and the number is expected to increase.

Advantages of Medicare Advantage

Some of the advantages of Medicare Advantages include: 

  • Convenient coverage options: With Original Medicare, you only get two types of coverage – medical insurance and hospital insurance. If you want extra coverage, you will need to opt for Medigap for supplemental coverage and Medicare Part D for drug prescription coverage. With the MA plan, you get all your coverage options in one convenient plan.
  • Personalized plan structures: MA provides different plan types for personal conditions. For example, if you have a chronic health condition, choosing an SNP Advantage plan can help with your medical costs. And, if you want provider freedom, a PFFS and PPO plan may be the right option for you.
  • Cost-saving opportunities: Research shows that you can save money on medical equipment and laboratory services by opting for an MA plan. Moreover, some MA plans have no costs for certain deductibles or premiums. Another significant benefit of MA is that there is an annual maximum out-of-pocket amount.
  • Coordinated medical care: Several MA plans are provided under structures that take advantage of coordinated medical care. This means that any Medicare Advantage providers you visit will be communicating with each other to offer effective, coordinated medical care.