Medicare Advantage - A Variety of Choices

Medicare was created in 1965 to provide senior citizens 65 and older and individuals with other qualifying health issues with medical coverage. When the program was first created, it consisted of two parts, Part A that covered inpatient hospital care and related expenses and Part B that covered outpatient care and related expenses.

In 1997, a new part became available. Part C was originally called Medicare + Choice and was developed to allow private insurance companies to offer program benefits. In 2003 that plan was changed to the Medicare Prescription Drug, Improvement, and Modernization Act, Medicare Advantage. Some rules changed to provide better benefits and lower costs.

Enrolling in a Medicare Advantage plan entitles the enrollee to the original covered services and to additional benefits depending on the chosen plan.

Private Fee-For-Service plans can be described as flexible yet costly. The flexibility comes in the choice you have regarding your medical care. Under this plan, an enrollee can see any approved healthcare provider who accepts the plan.
With PPO plan, enrollees will primarily see health care providers within the network. For a fee, however, providers outside the plan’s network can be seen. With this plan, referrals are not needed to see a specialist when medically necessary.
Medicare Advantage managed care plans typically are the best way to save money on health costs. Choice of health care providers is more limited than with other plans as that doctors within the network and hospitals within the service area must be used.

When this type of plan is chosen, a primary care physician is designated to oversee general care and make referrals to specialists.

There are many things to consider when choosing a Medicare Advantage plan. You will want to ask yourself some questions and give some thought as to which plan fits your situation best.

You will want to consider the cost of the premium and whether or not the plan has a deductible or co pay. You will need to know if the plan will cover any extra services you may need such as visual, dental or any sort of health and wellness program.

Will you be able to continue to see the doctors and other providers that you normally see? Does the plan provide prescription coverage