Medicare Advantage
Medicare Advantage, or Part C, coordinates your Original Medicare coverage to reduce your out-of-pocket costs for little to no monthly premium.
What Medicare Advantage Can Do for You
The Coleman Agency is always interested in you first. The question is, then, what can an Advantage plan do for you?
They help reduce your Medicare costs with a few additional benefits. There are 5 Advantage plans, each of which serves the same essential function—to coordinate a network of healthcare providers to offer you lower-cost Medicare services. Most Advantage plans will also include Part D prescription drug coverage, a huge and necessary benefit for many Medicare beneficiaries. And, with 5 different plans, you can make sure that you are getting the coverage you want at a reasonable price for your budget.
The Two Most Common Advantage Plans
Of the Advantage plans, Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) are the most common. Both of these plans have a structured healthcare network—when you seek out care within this network, your costs will be significantly reduced.
HMO is the least-expensive option of the two, with a more structured network. Most notably, you must have a primary care doctor and specialist referral. PPO is similar, but with a more flexible network at a slightly higher premium. You do not have to have a primary care doctor or specialist referral.
The High-Deductible Plan
Medical Savings Account (MSA) Plans have a high-deductible and savings account feature. Instead of paying a premium, you cover one larger yearly deductible. Most of the funds you pay for with this deductible that are not used on healthcare will go into a savings account for you to access at any time.
Another Potential Option
Private-Fee-For-Service (PFFS) makes you the negotiator of your own network. You must take your plan to doctors, hospitals, etc. and ask if they will accept the coverage. They are more expensive than other options, and take quite a bit more effort on your part. These plans are not especially popular, but still help Medicare beneficiaries immensely if it is for them. PFFS plans are most often used by individuals or couples who travel frequently and need to find healthcare providers in a variety of otherwise out-of-network locations.
Limited-Eligibility Plans
Advantage plans offer three Special Needs Plans (SNPs) to those with serious financial or health concerns. Dual-eligible SNPs (D-SNPs) are available to those enrolled in both Medicare and Medicaid, providing additional cost-coverage. They will include prescription drug coverage, and overall more out-of-pocket protection without a higher premium.
Chronic SNPs (C-SNPs) help those with life-threatening health issues receive coverage for the exact care they need. If you have a qualifying illness, you will receive coverage tailored specifically to your needs for the prescriptions, specialists, and more that you need.
Institutional SNPs (I-SNPs) provide coverage for those who are expected to or have had services provided to them for 90 days or more in an institutional setting, such as long-term care or a skilled nursing facility.
Call The Coleman Agency
No one knows you like you do. That’s why we work so closely with our customers to make sure that they are getting the exact insurance coverage they need for their health and budget. If you would like to see what we can do for you, call The Coleman Agency.
