Entering the 65 plus club means you have the opportunity to explore Medicare Advantage Plans, which are Medicare health plans offered by private companies.
These plans, also known as "Part C" or "MA Plans," provide you with all the benefits of Medicare Part A and Part B. Examples of Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Most Medicare Advantage Plans also include prescription drug coverage.
How do Medicare Advantage Plans function? When you enroll in a Medicare Advantage Plan, you still retain your Medicare coverage. However, instead of receiving your Part A and Part B benefits through Original Medicare, you obtain them through the Medicare Advantage Plan.
Medicare Advantage Plans cover all Medicare services, ensuring that you receive the same Part A and Part B benefits as Original Medicare.
These plans are designed to deliver Part A and Part B benefits to Medicare beneficiaries who choose to enroll in them.
Examples of such plans include Medicare Advantage Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).
It's important to note that Medicare Advantage Plans must adhere to Medicare's rules. Medicare pays a predetermined amount to the companies offering these plans on a monthly basis, and these companies must comply with the regulations set by Medicare. However, individual Medicare Advantage Plans may charge varying out-of-pocket costs and have different rules for accessing services. These rules can include requirements such as obtaining a specialist referral or using only doctors, facilities, or suppliers affiliated with the plan for non-emergency or non- urgent care. It's advisable to review and understand the specific rules of each Medicare Advantage Plan, as they may change annually.
When it comes to costs, Medicare health plans can have different factors contributing to your out-of-pocket expenses. These factors should be considered when evaluating and selecting a Medicare health plan.
In terms of prescription drug coverage, most Medicare Advantage Plans include this coverage.
However, if you're enrolled in a plan that doesn't offer drug coverage, you have the option to join a separate Medicare Prescription Drug Plan. It's important to note that you cannot have prescription drug coverage through both a Medicare Advantage Plan and a Medicare Prescription Drug Plan simultaneously. If you join a Medicare Prescription Drug Plan while being enrolled in a Medicare Advantage Plan with drug coverage, you'll be disenrolled from your Medicare Advantage Plan and return to Original Medicare.
As you navigate your options as a member of the 65 plus club, it's essential to explore and understand the details of Medicare Advantage Plans to make an informed decision about your healthcare coverage.