Understanding Medicare Advantage Plans

AARP Medicare Advantage Plans is the current option to cover medically necessary services in the United States. The plans cover much of the same services as the Part A program but are more limited in the scope of coverage and may provide fewer benefits. The plans will most likely cover some services other than those covered by the Part A programs but will not cover all of the services.For example, Part B plans will cover only the most essential medical care and services and Part C plans will cover dental and vision care. Medicare Advantage Plans also offers different coverage for home health, hospice, and skilled nursing facilities. Most Medicare Advantage Plans covers a wide range of services including preventive care, specialty care, ambulatory care, laboratory services, dental and vision care, prescription drugs, long-term care, and home health services.

The information available on these plans has been gathered from the Centers for Medicare and Medicaid Services (CMS) and has been released to the public as a means of helping consumers select a Medicare Advantage Plan that best meets their needs. These plans include the following:- HMOs are a type of PPO/PPO (Publicly-Paid Option / Private Plan) program that are preferred for many patients with chronic conditions and are sometimes the only choice for some traditional fee-for-service Medicare Advantage Plans. For example, if a patient lives in a rural area and does not live in close proximity to an inpatient facility, they may be unable to qualify for a traditional fee-for-service plan. Also, Medicare Advantage Plans often has provisions that allow patients to receive care at home instead of in a facility.

– Provider networks on AARP Medicare Advantage Plans are the networks of physicians and hospitals that work with Medicare and are able to accept members who enroll in the Medicare Advantage Plan. This may not be available in every state, however, and it is important for patients to learn about the provider networks on a Medicare Advantage plan so that they know what coverage they have access to and can choose a plan that includes their preferred physicians.- Prescription benefits on a Medicare Advantage Plan offer different medications at varying cost. It is important for patients to consider the costs of generic and brand name drugs to determine whether or not they are covered and what costs they would be. For example, Avodart is considered a generic drug and therefore is not covered by Part D.

– While not always available, Medicare Advantage Plans offer prescription drug benefits that cover a wide range of generic and brand name drugs. However, coverage for over-the-counter and prescription drugs must be approved by Medicare before being covered under the Medicare Advantage Plan.- Some plans include additional coverage for patients with chronic care. These plans will generally cover most routine care and preventative care, which provide additional coverage for patients who find themselves in a position where it is needed but requires ongoing, preventative care.

– Depending on a Medicare Advantage Plans policy, there may be a limit on the services covered. Patients should contact the Plan Administrator to find out more information on the services covered by the Medicare Advantage Plans and to ensure that their needs are met.- Seniors who are interested in visiting an emergency room for specialized care may want to look into Part C plans. Part C plans are designed to help seniors receive the same quality of care that they would receive in a hospital but with the savings associated with a Part A plan. Part C plans can be tailored to the unique needs of a senior citizen.

Since Medicare Part A policies require a patient to obtain health insurance or else pay a fee, many seniors find it difficult to obtain coverage for some of the more essential services. Part C plans provide seniors with the option to receive high quality medical care without a co-payment or fee. Today, there are several different types of Medicare Advantage Plans, each offering different services. Medicare Advantage Plans has the most potential for lowering costs and improving the overall quality of medical care in the United States. Anyone interested in Medicare Advantage should research and review each plan to ensure that the plan that meets their personal medical needs.