For Senior Citizens: Understanding Medicare Advantage Plans

Apr 11th, 2010 | By Sharon Shaw Elrod MSW EdD | Category: Social Security & Medicare

Trying to walk through the Medicare Maze remains a challenge for most of us senior citizens.  Perhaps taking just one piece at a time may be the best approach to gain better understanding of the whole picture.

Let’s talk about Medicare Advantage Plans.  Medicare Advantage Plans were created to satisfy the cry of the health insurance industry in the United States.  Original Medicare is the public option plan that is managed by the federal government and the insurance industry wanted a piece of the pie.  As a result, Medicare Advantage Plans were created so private insurance could participate in offering health insurance to senior citizens.

MA plans are available in many areas around the country.  Generally speaking, if you have a MA plan, you probably don’t have, and don’t need, a Medigap policy (policy that Medicare recipients get when then enroll in Original Medicare—sometimes called Medicare Supplemental Policy). 

MA plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans (PFFS), Medicare Special Needs Plans, and Medicare Medical Savings Account Plans (MSAs).  Some of these plans cover prescription drugs, and some require you to see certain doctors or use specified hospitals to get services that the plan will pay for.  Generally, these kinds of plans cover more services and have lower out-of-pocket costs than Original Medicare, or at least that’s what history reports.

However, beginning in 2010, we’re seeing some major changes in MAs.  Many of them are eliminating vision and dental coverage, and premium costs are going up.  Some speculate this is because these are private insurance plans, and a profit has to be made in order for them to survive.  A second reason may be related to changes on the national level.  The federal government is working to contain skyrocketing medical care costs, and streamlining programs is just one of the efforts the administration has taken to try to address the issues.

More information on Medicare Advantage Plans is available on the Internet.



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