Best Medicare Advantage Plans
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Medicare Advantage Plans

The insurance enterprise is a steadily growing industry. Medicare Advantage plans are very prominent, but often are confusing. Medicare Advantage plans are a different method used by Medicare-approved insurance companies for individuals to receive their Medicare benefits. In order to be eligible for a Medicare Advantage plan, you have to be a recipient of Medicare Part A and Medicare Part B. Medicare Part A is hospital insurance. Medicare Part B is medical insurance. Many elderly individuals are using the Best Medicare Advantage Plans because there are more added benefits which are obsolete from the “original Medicare” plan. All HMO plans, under Medicare Advantage, have a annual limit on your out-of-pocket costs that cannot be exceeded. This limit protects the insured from extra expenses if more tests or treatments are needed. Medical researchers reported in 2019 the maximum out-of-pocket allotment for HMO plans was roughly $6,500. However, HMO plans may set a lower maximum-out-of-pocket threshold.

Best Medicare Advantage Plans

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Most Common Medicare Advantage Plans

Health Maintenance Organizations (HMO)

This plan offers the same benefits and protection as the Original Medicare but different restrictions and cost may apply. This plan is paid by the federal government so that Medicare benefits can be administered. Some HMO Plans offer dental and hearing services, but most do not offer these services. In order to join an HMO plan, you must already have Medicare Part A and Part B. The insured will be responsible for paying their
Medicare Part B premium, unless the HMO plan agrees to split the cost of the premium. HMOs plan require you to seek health services from in-network providers for coverage, unless emergency assistance is needed. Some HMO Plans allow you to use out-of-network doctors for health services, but your out of pocket expenses will be greater. Also, if you choose to use an out-of-network doctor a prior authorization or referral is not needed, but you will incur more expenses.

A key factor for an HMO plan is that the insurance providers cannot charge more than Original Medicare charges for chemotherapy, dialysis, and skilled nursing facility (SNF) care. In the contrary, HMO may charge higher copayments for service such as, but not limited to : medical equipment, home health and inpatient hospital service. In addition, If you want prescription drug coverage (Part D), you must make sure this feature is included in your HMO plan. You cannot enroll in Part D prescription coverage plan solely, unless you have a Medical Savings Account (MSA) or Private Fee-for-Service (PFFS) plan that does not offer prescription drug coverage.

best medicare advantage plans

Preferred Provider Organizations (PPO)

The main difference from a PPO plan and an HMO plan, is a PPO sets 2 limits on the out-of-pocket expenses. Let’s look at an example. Let’s say your Medicare Advantage PPO plan has an out-of-pocket spending limit of $2,000 for in-network expenses and an out-of-pocket limit of $6,000 for your combined in-network and out-of-network expenses. You can reach the combined limit by spending $2,000 on in-network services and $4000 on out-of-network services, or by spending $6000 solely on out-of-network services. The benefit of having 2 limits on the out-of-pocket expenses is not just to save money, but to protect you from uncontrollable events that often happen in life. PPO Plans offer vision and dental annual screenings, as well as hearing services.

best medicare advantage plans

Private Fee-For-Service (PFFS)

The sole purpose of this plan is to determine how much it will pay doctors, healthcare providers and hospitals, as well as determine your copayments for the aforesaid services. This plan allows you to obtain service from any Medicare-approved doctor that will accept the terms and conditions of the plan. Most PFFS plans have a set contract with certain providers who will agree to provide services to you even if they are not your primary care physician. Moreover, no referral is needed to see a specialist. This plan is designed to offer extensive medical services at a low price.

best medicare advantage plans

The aforementioned Medicare Advantage plans are simply the most common plans, but not the only plans available. For example, Medicare recipients may be interested in the Medicare Medical Savings Account, or MSA plan. This plan has a high deductible health plan (HDHP) and provides the insured with a bank account. In order to receive health coverage, you must meet a high deductible amount. This high deductible health plan requires the insured to pay for most of their health services upfront until the deductible has been reached for the year. Once the deductible is met, this plan will pay for all your medical expenses for the year. The bank account provided by this plan is strictly used for the plan to deposit funds once a year for all medical expenses. The funds can be used to pay for your deductible. No outside deposits can be made into this banking account. Generally speaking, the plans monetary contribution will be lower than the amount of the deductible. Remember as long as the money deposited into your MSA plan is used on qualified medical expenses, the funds are not taxed.

Best Medicare Advantage Plans

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Which Medicare Advantage Plan is Right for You ?

Due to the steadily rising need for health insurance, many private insurance companies offer various types of Medicare Advantage Plans. Let’s discuss the top-rated insurance companies for Medicare Advantage plans.

Humana

Humana 

Humana HMO plans are comprised of the following benefits:


  • Prescription drug coverage equal to or greater than the original Medicare offered by the federal government
  • Affordable, low monthly premium cost. Some Humana HMO plans offer a monthly premium amount of $0.
  • Your choice of primary care physician within the insurance providers list of in-network doctors
  • Nationwide emergency medical services coverage
  • Annual preventative screenings for dental and vision services
  • 
Free membership for SilverSneakers program

 

Humana PPO benefits include:

  •  Home health-care for in-network health providers
  • Higher premium costs which cover prescription drugs, dental and vision services
  • 
Free preventative screenings for dental and vision screenings
  •  International emergency service coverage
Aetna

Aetna HMO benefits include : 


  • Must use a provider within the network unless emergency treatment is needed
  • Most plans require you to select a primary care physician
  • Most plans require a referral to see specialists
  • Monthly premiums range from $0-170 dollars
  • Medical deductibles range from $0-1100 dollars
  • 
A cap is placed on out-of-pocket medical expenses to save money
  • 
Most plans have prescription drug coverage and will mail prescriptions to the home free of charge
  • Certain over the counter drugs are free of charge
  • Some plans offer transportation to get to and from doctor appointments
  • Most plans will deliver meals to the home after a person has stayed in the hospital (specific plan details apply).

 



Aetna PPO benefits include : 


  • Does not require you to use an in-network doctor
  • Referrals are not needed for specialists
  • Monthly premiums range from $ 0-210 dollars
  • Medical deductibles range from $0-1700 dollars
  • Most plans have prescription drug coverage and will mail prescriptions to the home free of charge
  • Certain over the counter drugs are free of charge
  • Some plans offer transportation to and from doctor visits
  • Most plans will deliver meals to the home after a person has stayed in the hospital (specific plan details apply)
  • Fitness benefit through SilverSneakers program

Currently, over 20 million Americans are enrolled in a Medicare Advantage plan. Medicare Advantage plans were designed to help individuals age properly with optimal health care benefits in mind. In order to decide which plan is right for you, please speak with a Medicare expert or provider representative. Making an informed decision about your healthcare needs is always wise. Please visit www.medicare.gov for additional information.

Best Medicare Advantage Plans

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