Considering a Medicare Part Advantage plan? This guide will explain what Medicare Advantage is, how these plans work, what they cover, and the pros and cons compared to Original Medicare.
Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B). Introduced in 2003, Medicare Advantage plans provide an option beyond traditional supplemental plans. When you enroll in a Medicare Advantage plan, you transition out of the Original Medicare system and into a private network managed by your insurance carrier. Because this private network replaces Original Medicare coverage, Medicare Advantage plans are often referred to as replacement plans.
With a Medicare Part C plan, a private health insurance company becomes your primary coverage provider, meaning you’ll use just one card for all your healthcare needs, simplifying the process.
It’s important to remember that Medicare Part A and B cover preventive services, medically necessary treatments, inpatient hospital care, and skilled nursing facility stays. However, outside of an annual exam, you’ll be responsible for the costs of any additional doctor’s visits throughout the year. Elective surgeries are generally not covered by Original Medicare, which could result in significant out-of-pocket expenses.
In contrast, Medicare Advantage plans often offer coverage for both preventive and elective health services, providing a broader range of benefits compared to Original Medicare.
Medicare Advantage plans often serve as a one-stop-shop by covering the same services as Medicare Part A and Part B, while also providing additional benefits not included in Original Medicare, such as vision, dental, hearing, and prescription medications.
These plans usually offer extensive coverage with relatively low monthly premiums, many even having a $0 premium. However, Medicare Advantage plans typically use a pay-as-you-go system, meaning that the frequency of your plan usage will affect your out-of-pocket costs for treatments.
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When deciding whether to enroll in a Medicare Advantage plan, consider factors such as your monthly insurance budget and your willingness to pay out-of-pocket costs. Medicare Advantage plans also offer a 12-month trial period, giving you the opportunity to determine if the plan suits your needs.
Retirees with TRICARE or FEHB benefits often opt for Medicare Advantage plans because these plans allow them to retain their existing benefits, unlike Supplemental/Medigap plans.
No matter when you choose to enroll in Medicare, Martindale Financial Group will be here to help you.
We help you understand your eligibility and determine the best time to enroll in Medicare based on your unique circumstances.
At Martindale Financial Group, our mission is to make Medicare easy to understand so you can enjoy your retirement with confidence. Explore our blog or visit our YouTube channel for valuable info on Medicare and Social Security.
For personalized assistance, schedule an appointment with a us or give us a call today.
Dain Martindale is an Independent Insurance Agent offering Medicare, Life, and Health care products at affordable rates and can write policies for most major carriers. Licensed in Florida serving the Tarpon Springs community and beyond.
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Currently we represent most major carriers in your area. You can always contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.
