Introduction

We here at Meadowcrest Family Physicians are advocating for better health through education. We urge our patients to consider the different healthcare plans available to them as we have seen so much success with many patients that have made the switch. Obtaining the best health coverage is a balance between affordability and quality. Researching different Health Care options may feel daunting as policies, regulations, prices, coverage, and more are complicated and constantly changing. For many of our patients, a medicare advantage plan is not only just good insurance but is the ideal way to cover their medical needs. Read this article to learn about the medicare advantage plans you may be eligible for and why we recommend them.

What is a Medicare Advantage Plan? (and is it good insurance)?

You may be familiar with Medicare Advantage Plans, Medicare Part C, or Medicare Advantage (MA)  but what it is important to know is that Medicare Advantage is a supplemental program for providing additional Medicare benefits and coverage. Medicare Advantage Plans are typically associated with managed care plans. While these Health Management organizations (HMOs) and Preferred Provider Organizations

(PPOs) have limited provider networks, they are required by law to have increased coverage requirements compared to standard Medicare.

As is true with standard Medicare, Coverage must include Part A (inpatient hospital) and Part B (outpatient) services. Many of the Medicare Advantage Plans also include Part D (Prescription Drug) coverage. Additional services are also often included such as transportation to appointments, gym memberships, and even health spas. 

What you may not know is that in 2022 over 48% of Medicare beneficiaries are signed with some form of Medicare Advantage Plan. You may be surprised to learn that nearly all Medicare members are eligible for at least one Medicare Advantage Plan.

Various Medicare Advantage Plans Available.

You might have heard inaccurate details in the past regarding Medicare Advantage Plans, often regarding care networks and approved doctors. The plans available are as diverse as the people they serve and have many options to consider. Researching different plans can be daunting but having the right one means saving money on the care you need. At Meadowcrest we accept various Humana medicare advantage plans to ensure after you switch you can keep your same primary care physician at Meadowcrest.

Health Maintenance Organization (HMO) Plans

  • In HMO Plans, the member is generally subjected to a plan’s care network. This means you must get your care from doctors, and hospitals in the plan’s network. There are exceptions for emergency and out-of-town care to make sure you always have options to ensure the best care.

Preferred Provider Organization (PPO) Plans 

  •  Offered by a private insurance company, PPO plans offer discounts to in-network doctors and hospitals but offer more flexibility on where the member can receive care.

Private Fee-for-Service (PFFS) Plans

  • A private insurer determines the amount it will pay when you get care. Doctors, Hospitals, and other health services can refuse to treat based on this amount, but you as the patient are not restricted to any networks that may limit your options.

Special Needs Plans (SNPs)

  • Medicare SNPs limit membership to people with specific diseases or characteristics. Click the link above if you think you may be a candidate for one of these programs.

The History of Medicare Advantage

Americans have been using Medicare Advantage plans to cover their health care expenses since 2006. The program was launched to expand coverage while allowing members the freedom to choose their plans. Since then membership has grown to include over 28 million seniors in the United States.

Who can join a Medicare Advantage Plan?

Your Medicare Advantage Plan is meant to replace your existing Part A and B Medicare benefits. Nearly all members of medicare are eligible for a Medicare Advantage Plan.

To join a Medicare Advantage Plan, you must:

  • Have existing Part A and Part B benefits.
  • Live in the plan’s service area.
  • Be a U.S. citizen or lawfully present in the U.S.

Takeaway

Regardless of health Insurance policy, you can be assured that your health care is our number one priority. We have found that our patients are getting better benefits with Medicare Advantage Plans and strongly recommend that you explore your Medicare Advantage options.

At Meadowcrest Family Practitioners our commitment to care goes much beyond our office. If you need additional information regarding Medicare Advantage we have resources to help. Please make an appointment with our in-office rep to learn your options.