Medicare Advantage Health Insurance Plans
Comprehensive Medicare Insurance and Prescription Drug Coverage
Nov 3, 2009
Some Medicare beneficiaries (who receive Original Medicare Parts A and B) complete their health insurance coverage by purchasing a supplemental Medigap policy, while others choose to enroll in Medicare Part D for supplemental drug coverage.
However, it is also possible to purchase a comprehensive Medicare Advantage Plan (Part C), which provides a full range of benefits in just one policy.
What is Medicare Advantage Health Insurance?
Medicare Advantage Plans, while approved by Medicare, are individual health insurance policies sold by private insurance companies, such as Humana and Aetna. Similar to HMOs and PPOs, Medicare Advantage Plans offer comprehensive health insurance run by private insurers, yet is approved by and considered a part of Medicare insurance.
Medicare Advantage Health Insurance Benefits
By purchasing a Medicare Advantage Plan, beneficiaries generally have access to the following benefits:
- All of one's base Medicare insurance coverages are provided;
- Prescription drugs are covered, making it unnecessary to enroll in Medicare Part D for supplemental health insurance;
- Additional benefits, such as dental and hearing, are often included;
- Out-of-pocket expenses (such as copayments) are often much lower than in other plans;
- There is little need to purchase Medigap supplemental Medicare insurance.
It should be noted, however, that Medicare Advantage health insurance premiums, given the broad coverages offered, are often higher than individual, supplemental policies. Of course, this is dependent upon which individual policies are being compared, as they vary greatly. (Consumers may want to compare the costs of Medigap policies when considering health insurance options.)
Different Medicare Advantage Health Insurance Options
Broadly speaking, there are a number of different types of Medicare Advantage policies to consider, and include some of the following:
- Health Maintenance Organization (HMO) – a form of Medicare insurance that is offered in most of the U.S. These plans are obligated to provide Medicare Parts A and B, and often contain a number of additional coverages. Just as with standard HMO private plans, beneficiaries must stay within an approved list of doctors and hospitals for routine or scheduled care.
- Preferred Provider Organization (PPO) – a form of Medicare insurance which works similar to standard PPO plans in that beneficiaries are rewarded with lower copayments if they seek care within an approved network of medical professionals and facilities. And just as with standard PPO plans, Medicare Advantage PPO plans allow beneficiaries to use any doctor or facility residing outside of a given network (but at additional costs).
- Private Fee-for-Service Plan – this plan is more volatile in terms of cost variation, as private insurers set costs and fees independently. However, the upside is that this type of plan allows for beneficiaries to see any doctor or facility approved by Medicare insurance.
- Medicare Medical Savings Account (MSA) – this plan has two distinct parts. The first is a comprehensive Medicare Advantage insurance plan which typically has a very high deductible. However, the second part helps offset the high deductible, as it consists of a "Medical Savings Account," a reservoir into which the government can place money for beneficiaries to use for Medicare insurance or other health insurance costs.
- Medicare Special Needs Plan (SNP) – this is a unique Medicare Advantage plan which includes not only all base Medicare insurance coverages, but also "special care for chronic illnesses, care management of multiple diseases, and focused care management."
With all of the above Medicare Advantage plans, costs vary depending upon the particular private insurance company from which a plan is purchased, the individual policy which is purchased, and the region in which a policy is purchased.
For more detailed, technical information on Medicare Advantage Plans, visit either an individual private insurance provider's website, or Medicare.gov, where the information for this article was gleaned.
 |
 |
 |
