Medicare Advantage Plans Explained for Seniors

Oct 3rd, 2010 | By | Category: Social Security & Medicare

The 2010 Medicare Annual Election Period is nearing and SCJ continues its discussion about what senior citizens need to know about Medicare.  The Annual Election Period (AEP) begins Novesmber 15 and continues through the end of the year.  During this time, seniors can change plans if they want, and of course, those who are not already enrolled can do so.

Last week we talked about Medigap or Supplemental insurance plans, those additional policies we seniors purchase to fill in the gaps with Original Medicare Parts A and B.  This week we want to talk about Medicare Advantage Plans (Part C) which are medical insurance plans offered by private companies; they were added in 1997 with the Balanced Budget Act, to give Medicare participants more choices about how they receive their health care. That’s why you’ll find several different kinds of plans in this category.

Wikipedia says this about Medicare Part C: ”
With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as Medicare Advantage.

Medicare Advantage plans are all offered by private companies that have been approved by Medicare. To encourage competition, Medicare gives these private companies flexibility in setting the terms of each plan. That means you’ll find differences among plans as you shop.

There are three basic kinds of Medicare Advantage plans:

  1. Coordinated Care:  in these plans, a primary care physician has responsibility for coordinating your medical care with physicians and hospitals; you likely will not have a choice of either doctor or hospital in the kind of plan;
  2. Private Fee For Service plan: in these plans, care is not coordinated; you can seek care from a doctor/hospital who is covered by the plan;
  3. Medical Savings Account: again, care is not coordinated; you are free to find a physician/hospital that carries the plan; MSAs permit you to use pre-tax dollars to place in a ‘savings account’ and you draw on that account to pay your approved medical bills;

If you are interested in a Medicare Advantage plan, you really need to do your homework to be sure your medical needs will be met and cost will be efficient for you.  More detail is offered here about the questions you need to think about.

The Official Medicare site offers you the option to enroll online; SCJ readers are encouraged to register on the Medicare site and make effective use of all the services it offers.  It’s very user friendly and a huge help to those of us who are Internet-saavy.

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  1. […] (Part A), in doctor/medical offices (Part B), privately offered senior health care known as Medicare Advantage (Part C), and prescription drug services (Part D).  Seniors living on a fixed income that is low […]

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